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

INTRODUCTION: Gonadotropins are released under the control of gonadotropin-releasing hormone (GnRH) from thearcuate nucleus and preoptic area of the hypothalamus. The gonads — testes and ovaries — are the primary targetorgans for LH and FSH. The gonadotropins affect multiple cell types and elicit multiple responses from the targetorgans. As a simplified generalization, LH stimulates the Leydig cells of the testes and the theca cells of the ovaries to produce testosterone (and indirectly estradiol), while FSH stimulates the spermatogenic tissue of the testes andthe granulosa cells of ovarian follicles.Reproductive aging is endocrinologically characterized by a progressive rise in serum FSH levels associated with adecrease in serum estradiol (E2) and testosterone (T) levels. The rise in FSH is associated with reduced levels of sexsteroid and peptide negative feedback regulators of FSH secretion.The aim of study is: determination of serum FSH level changes in relation to aging and sex.MATERIALS AND METHODS: In this study were involved 169 healthy Mongolian adults aged above 45 years old. Subjectswere randomly selected and undergone physical examination by geriatrician. People, who are receiving hormonereplacement therapy, using inproper use of alcohol, injured and had surgery were excluded from our surgery. Bloodsamples were collected in the early morning (8.30–10.30 AM) after an all night fast and plasma was separatedimmediately by centrifugation; then sera obtained were stored at -20°C until assayed by ELISA kit from United BiotechCoLTD, USA, which sensitivity is 1mIU/ml. Statistical analyses have been performed by statistical software SPSS 16,using ANOVA, Pearson correlation, T-test.RESULT: Mean level of FSH for both sexes was 21.19±16.2 mIU/ml, which is in comparison with males (12.33±10.58mIU/ml) it was comparatively higher (p<0.001) in women (29.61±16.15 mIU/ml). FSH has no correlation with aging inman (r=0.084, p>0.05), but in women it was stronger correlation (r=0.203, p<0.05). in 51-60 years age group FSH wasincreased by 56%, in 61-65 years group by 91%, in 66-70 years group it was increased 100% in comparison with until50 years age group. In older age (above 70 years) it decreased to 70% from reached concentration. ANOVA analysishas not showed significant difference between age groups.CONCLUSIONS: Average mean of FSH in old age are: 29.61±16.15 mIU/ml in women and 12.33±10.58 mIU/ml in men.Correlation with aging was observed stronger in women than in man (r=0.203, p<0.05). FSH increases with aging untilround 70 and decreases after 70 years old.

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:In females reproductive system aging is very important. Females spend the last 1/3 period of their life in insufficiency of sex hormone of late menopause. Due to decrease of ovary function noticeable change is detected in nervous endocrine system. Although menstrual cycle hasn’t been lost amount of FSH increased. It shows decrease of reproductive function females. Therefore recently researchers define that amount of FSH increase is an important biomarker which detects in an early period of menopause. But amount of estradiol hormone is almost in normal level until the late post menopause. Goal: to study the dynamic feature of age related changes and dependence of serum FSH and estradiol level in female aging.Materials and Methods:In this study were involved 177 healthy Mongolian women aged above 35 years old. We drained 5 ml fasting vein blood at 8.00-10.00 am. Sera were separated and kept frozen until assayed by ELISA. Results:Аaverage mean of FSH was 19.84±22.6 IU/l, at the age of 35-45 1.62±3.29 IU/l, at the age of 46-55 16.39±15.39 IU/l, at the age of 56-65 31.38±33.69IU/l, at the age of 66-75 28.83±17.31 IU/l, over 75 34.52±13.94 IU/l and there was positive correlation between age and FSH levels (r=0.647, p<0.001).Average mean of estradiol of participants: at the age of 35-45 37.03±22.09 pg/ml, at the age of 46-55 21.1±16.65pg/ml, at the age of 56-65 13.7±20.07 pg/ml, at the age of 66-75 9.11±15.1pg/ml, over 75 age 1.8±1.53 pg/ml and there was inverse correlation between age and estradiol levels (r= -0.453, р<0.001).There was an inverse correlation between log E2 and FSH levels (r= -0.434, p<0.001). Multiple regression analysis shows that age (β= -0.350, p<0.001) and FSH (β=-0.222, p=0.016) had significant inverse correlation with serum estradiol level. Conclusion: For females over 35 average mean of FSH is 19.84±2.26 IU/l, average mean of estradiol hormone is 19.6±2.0pg/ml. between the mid age (35–45 years) and oldest (>75 years) groups, mean estradiol level declined by 20.6 times, whereas FSH increased by 21.3 times. It shows that this is an important marker of menopause. Multiple regression analysis shows that age (β= -0.350, p<0.001) and FSH (β= -0.222, p=0.016) had had significant inverse correlation with serum estradiol level.

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.

Background: The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Major changes in the vaginal physiology and microbiota over a woman’s lifetime are largely shaped by transitional periods such as puberty, menopause and pregnancy. Many studies have shown that bacterial vaginitis (BV) has an increased risk of preterm birth, miscarriage, premature rupture of membran, and postpartum uterine inflammation and sepsis. To assess different bacterial and epidemiological factors associations with increased vaginal pH in the women of reproductive age. Methods: In the 1st Health center of Bayanzurkh district hospital, 100 non-pregnant women were randomly selected between 18-45 years of age. Women were submitted to an interview, vaginal examination and vaginal specimen collection for pH measurement and microscopy. Descriptive statistics are reported for the vaginal pH according to a specially designed survey card, the survey respondents assessed the status of the mother’s health. Results: The non pregnant group studied herein were mostly young adults with ages in the age range 25-29 (32.0; 32%, mean±SD: 29.1±5.7) years. The vaginal pH mean in non-pregnant women was 4.5±0.5. Elevated vaginal pH was signicantly associated with bacterial vaginosis (p < 0.001), and bacterial vaginosis flora (p < 0.001). 162 of 200 women (81%) had an increased vaginal pH. 65,8% of participants in research were normal nugent score. Conclusion In non-pregnant women, the vaginal pH mean was 4.5 ± 0.5. Changes in vaginal pH are statistically significant with age, and clinical manifestations. /р<0.05/. The human vaginal ecosystem is a dynamic environment in which microbes can affect host physiology but also where host physiology can affect the composition and function of the vaginal microbiota.

BackgroundLeptin is a mediator of long-term regulation of energy balance, suppressing food intake and therebyinducing weight loss.GoalThe main goal of our study was the analyzing of serum leptin level in correlation with some influencingfactors in adults with metabolic syndrome.Materials and MethodsWe included 260 randomly selected people aged 18-72 years old; among them 105 had metabolicsyndrome which was identified by the criteria of the International Diabetes Federation. All participantsunderwent general medical examinations and signed a written consent paper. Fasting blood glucose,triglyceride, HDL-C, insulin, adiponectin, leptin level were measured in fasting blood serum and insulinresistance was calculated as a HOMA-IR model.ResultsAverage level of leptin for participants with MS was 16.44±14.21ng/ml, in participants without MS was9.59±12.69ng/ml. MS exposed group had much higher level of leptin than the control group (p<0.001).Leptin level was correlated with waist circumference (β=-0.253±0.1; p=0.013), and body mass index(β=1.778±0.274; p<0.001).ConclusionLeptin level in the MS exposed group were higher than in the control group. The level of leptin had aconsistent and significant correlation with body mass index and waist circumference in compare to otherinfluencing factors.

Introduction. The metabolic syndrome is related to increased risk of developing cardiovascular disease andtype 2 diabetes. Adiponectin is an adipose tissue-specific collagen-like factor, which is abundant in plasma, anda decrease of adiponectin is associated with obesity and type-2 diabetes.Goal. This study aimed to determine the ADIPOQ gene -11377 polymorphism in association with plasmaadiponectin level and risk factors of metabolic syndrome.Materials and Methods. We investigated adiponectin gene -11377C>G polymorphism in 156 subjects withmetabolic syndrome and 142 healthy control subjects. The -11377C>G polymorphic locus was amplified using theforward primer 5’-ACTTGCCCTGCCTCTGTCTG-3’ and the reverse primer, 5-CCTGGAGAACTGGAAGCTG-3’.A p value <0.05 was considered statistically significant.Results. Adiponectin level positively correlated with age, but correlated negatively with TG, waist circumference,waist hip ratio, diastolic blood pressure, weight and BMI (p < 0.05). With genotype CG and GG (6.57±3.09ng/ml) of -11377C>G had lower levels of serum adiponectin than those with the genotype CC (7.38±3.68ng/ml) butno significant difference in people with MS (p=0.157). Therefore with genotype CG and GG (168.56±113.31mg/dl) of -11377C>G had higher levels of serum triglycerides than those with the genotype CC (132.94±74.78mg/dl) significant difference in people with MS (OR=1.006, p=0.015). With CG and GG (75.04±12.49mg/dl) of-11377C>G had significantly higher glucose level compared to with the genotype CC (68.85±11.76mg/dl) inwithout MS (OR=1.071, p=0.017).Сonclusions.1. ADIPOQ gene -11377>G polymorphism of the adiponectin gene was found not to be related to adiponectinlevel (p=0.157).2. -11377C>G polymorphism was related to the metabolic syndrome susceptibility, and this polymorphismimpacted on circulating triglyceride and glucose concentrations.

Introduction: The metabolic syndrome (MS) is characterized by central obesity, hypertriglyceridemia,low high-density lipoprotein (HDL), increase blood pressure and raise fasting plasma glucose. ThePGC-1α gene is located on chromosome 4 p.15.1 in humans and encodes a protein containing 798amino acids. The protein encoded by this gene is a transcriptional coactivator that regulates thegenes involved in energy metabolism. PPARγ, a coactivator molecule recently identified based on itsability to interact with PPARγ, is involved in many important metabolic processes, including adaptivethermogenesis, mitochondrial biogenesis and fatty acid β–oxidation.Goal: To study the frequency of PGC-1α Gly482Ser polymorphism in people with MS in relation to therisk factors of the MS.Materials and methods: The study population comprised 302 unrelated Mongolian subjects (158 withmetabolic syndrome and 144 controls). The genotypes for polymorphism of candidate gene related toMS were determined using a RFLP analysis of the MspI digest of the PCR product.Result: From the control group, 33.4% (48) had GG, 47.2% (68) had GS and 19.4% (28) had SSgenotypes. 51.9% (82) of people with MS had GG, 35.4% (56) had GS and 12.7% (20) had SSgenotypes. The prevalence of G allele in people with MS was 69.6%, which is much higher than healthygroup. Comparing PGC-1α Gly482Ser GG, GS and SS genotypes with systolic arterial blood pressurerevealed statistically significant difference which was higher among subjects with GG genotype. Theblood pressure of people with MS and carrying GG genotype of PGC-1α Gly482Ser polymorphismwas significantly increased 2.35 times than people without MS.Conclusions:1. 69.6 percentages of the people with MS had G allele and 2.2 times more than those withoutmetabolic syndrome.2. We determined that the odds ratio for the high blood pressure and it was 2.35 times higher inpeople with GG allele of Gly482Ser carriers than GS and SS alleles carriers (OR = 2.35, p =0.012).