Introduction. Arterial hypertension (AH) is one of the main causes of the cardiovascular diseases (myocardial infarction and heart failure). Arterial hypertension leads to complications such as cerebral insult, myocardial infarction, coronary artery disease, renal dysfunction and heart failure [2]. In our country, AH composes 41.8% of the cardiovascular diseases. 52% of the mortality due to cardiovascular diseases results from AH and its complication – cerebral insults [4]. It is obvious in the world that obesity and overweight as main risk factors of the AH influence negatively on human body and affect health harmfully. There, in our country, some studies have been conducted on prevalence of the AH and obesity. But there is no study that reveals correlation between obesity and arterial hypertension, therefore, the study aimed to study it. Aim. The study aims to establish correlation between arterial hypertension and overweight/obesity among Mongolian people. Materials and Methods: In the study have been involved 3411 people aged of 15-64. Out of them 1674 (49%) were men and 1737 (51%) were women. AH classification was used according to the National Guidelines of the Arterial Hypertension for Mongolian adults. In the study outcome analysis, the statistical program SPSS-12.0 was used for data creating, checking, processing and compiling of the results. Difference in the parameters was evaluated by Chi quadrates. Results: Among people involved in the study, 29.3% had arterial hypertension and 70.7% had normal blood pressure. 18.6% of the total studied people had AH of I degree, 6.2% - AH of II degree and 4.5% - AH of III degree. By regions of AH prevalence, in Ulaanbaatar, AH was 30.2%, in the Western region - 29.4%, in the Khangai region - 28.3%, in the Central region - 28.2%, in the Eastern region - 29.8%. There was no significant difference in AH prevalence for the regions (ℵ2=11.715, p<0.469). For overweight, obesity, by regions, in the Central region and Ulaanbaatar, overweight and obesity rate was higher than in other regions. The highest rate of the overweight, obesity observed in the people aged of 35-44 years (29.7-38.6%) which are most active ages for employment. Conclusions: 1. Arterial hypertension incidence frequency correlated with Body Mass Index. 2. Arterial hypertension incidence becomes more frequent with increase in Body Mass Index. 3. Risk of arterial hypertension is 1.8 more frequent in I degree, 4.2 more frequent in II degree, 19 more frequent III degree of the obesity.

We present the fi rst 2 cases of cochlear implantation in Mongolia using “SONATA” type implant of “MED-EL” Company, Austria. CASE 1: A six years old, female had been diagnosed with bilateral congenital profound hearing loss and had been fi tted with hearing aids for 5 years and received little benefi t from her hearing aids and developed very poor speech and language, used lip reading and have had vocabulary of approximately 10 words. A radiological evaluation showed normal cochlea and auditory nerve. Cochlear implant team including speech therapists and audiologists based on the informed consent of patient’s parent decided that family able to participate in follow-up, speech habilitation programme. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. After 10 days of switch on of the speech processor the patient showed signs of initial hearing of loud sounds. After 5 months of Auditory Verbal Therapy the vocabulary increased up to 50 words. Hearing, cognition and responses are increasing simultaneously. CASE 2: A 2 years old female. Congenitally deaf in both ears. Fitted with hearing aid for 3 months before the surgery and there was no benefi t from hearing aid. Physically and mentally healthy. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. On 25th days of switching on of speech processor the patient showed initial hearing of loud sounds. Currently, after 5months of treatment her vocabulary is 2 short words and can recognize 4 syllabeles. She is very active, repeats actions and has open nature, feels comfortable with CI.

Background Mongolia has been undergoing an epidemiological transition since 1990s. As a result, lifestyle and health behavior related diseases such as cardiovascular diseases, diabetes, cancer and injuries are growing steadily and have become the leading causes of population mortality. According to the Mongolian STEPS Survey on the Prevalence of NCD Risk Factors (2009), the summary of combined NCD risk factors demonstrates that 1 in 5 (26.4%) Mongolian adults have three or more common modifiable NCD risk factors and consumption of alcohol in the past 30 days was reported by 38.6% of the population. Goal The goal of the survey was to determine the prevalence of alcohol consumption among Bugat soum population of Bulgan province. Materials and Methods The cross-sectional survey used a questionnaire of the WHO STEPS survey and adapted it to the local specifics. Alcohol consumption was assessed using the concept of “standard drinks”. A total of 201 randomly selected 15-64 year old residents of both sexes of Bugat soum were involved in the survey. The survey data was collected in September, 2011. The survey data was fully collected using small handled computers (PDAs). Results The survey respondents, 30.3% consisting of males (16.9%) and females (41.2%) were past 12 months abstainers. Of the alcohol users, 69.7% (males 83.1% and females 58.8%) reported drinking during the past 12 months and 47.3% were current drinkers or reported alcohol use during the past 30 days. In contrary, 60.9% of males and 36.8% of females were current drinkers or reported alcohol use during the past 30 days. In terms of the frequency of alcohol use by respondents reporting drinking in the past 12 months, 39.3% drank occasionally, 21.4% drank alcohol for 1-3 days a month, 2.5% drank 1-4 days a week, 4.5% drank 5-6 days a week, and 2.0% reported daily consumption of alcohol. Conclusions The survey results showed that current drinking or consumption of alcohol in the past 30 days was reported by 47.3% in herdsmen of Bugat soum. Of these 60.9% are men and 36.8% are women. As for the quantity of consumption, the current drinkers consumed 13.3 standard drinks for men and 5.0 for women. Frequency of alcohol drinking was higher in males compared to females. The prevalence of binge drinking was 2.5% in men and 0.4% in women, and binge drinking was 6 times more common in males compared to females.

ҮНДЭСЛЭЛ: Миоген онолоор тайлбарлагдах зүрхний шигдээс нь аажим явцтай, зүрхний бах ба зүрхний архаг дутагдлын хам шинжээр хавсран илэрдэг бөгөөд эмчилгээ нь тромбогенийн онолоор тайлбарлагдах шигдээсийн үеийн эмчилгээнээс ялгаатай байдаг. Тиймээс бид байгаль газар зүйн өвөрмөц нөхцөлтэй манай оронд ЗШ-ийг үүсгэж буй шалтгаан, түүний эмнэл зүйн илрэлийн онцлогийг судлан тогтоож, цаг алдалгүй зөв оношилж, хүндрэлийг багасгахыг зорьлоо. ҮР ДҮН: Монголчуудын дунд ЗШ нь багтраат, тархи судасны, хэвлий гэдэсний, хэм алдагдах, зүрхний дутагдал, шинж тэмдэг бүдэг зэрэг сонгодог бус хэлбэрүүдээр илэрч байна. Монголчуудын дунд илэрч буй ЗШ харьцангуй хөнгөн явцтай байгааг бидний судалгаа харуулж байна. Мөн манай орны нөхцөлд миогенийн онолоор тайлбарлагдах шигдээс зонхилж байгааг харуулж байв. ДҮГНЭЛТ: Манай орны нөхцөлд миогенийн онолоор тайлбарлагдах шигдээс зонхилж, харьцангуй хөнгөн явцтай, ЗШ-ийн сонгодог бус өвдөлттэй хэлбэр давамгайлан, эмнэл зүйн хэдэн хэлбэрээр хавсран тохиолдох нь элбэг байна.

Introduction. Arterial hypertension (AH) is one of the main causes of the cardiovascular diseases (myocardial infarction and heart failure). Arterial hypertension leads to complications such as cerebral insult, myocardial infarction, coronary artery disease, renal dysfunction and heart failure [2]. In our country, AH composes 41.8% of the cardiovascular diseases. 52% of the mortality due to cardiovascular diseases results from AH and its complication – cerebral insults [4]. It is obvious in the world that obesity and overweight as main risk factors of the AH influence negatively on human body and affect health harmfully. There, in our country, some studies have been conducted on prevalence of the AH and obesity. But there is no study that reveals correlation between obesity and arterial hypertension, therefore, the study aimed to study it.Aim. The study aims to establish correlation between arterial hypertension and overweight/obesity among Mongolian people.Materials and Methods: In the study have been involved 3411 people aged of 15-64. Out of them 1674 (49%) were men and 1737 (51%) were women. AH classification was used according to the National Guidelines of the Arterial Hypertension for Mongolian adults. In the study outcome analysis, the statistical program SPSS-12.0 was used for data creating, checking, processing and compiling of the results. Difference in the parameters was evaluated by Chi quadrates.Results: Among people involved in the study, 29.3% had arterial hypertension and 70.7% had normal blood pressure. 18.6% of the total studied people had AH of I degree, 6.2% - AH of II degree and 4.5% - AH of III degree.By regions of AH prevalence, in Ulaanbaatar, AH was 30.2%, in the Western region - 29.4%, in the Khangai region - 28.3%, in the Central region - 28.2%, in the Eastern region - 29.8%. There was no significant difference in AH prevalence for the regions (ℵ2=11.715, p<0.469). For overweight, obesity, by regions, in the Central region and Ulaanbaatar, overweight and obesity rate was higher than in other regions. The highest rate of the overweight, obesity observed in the people aged of 35-44 years (29.7-38.6%) which are most active ages for employment.Conclusions:1. Arterial hypertension incidence frequency correlated with Body Mass Index.2. Arterial hypertension incidence becomes more frequent with increase in Body Mass Index.3. Risk of arterial hypertension is 1.8 more frequent in I degree, 4.2 more frequent in II degree, 19 more frequent III degree of the obesity.

Introduction. The survey was conducted to establish the midterm evaluation of the National Program on NCD Prevention and Control, and to establish baseline data for a health project funded by the Millennium Challenge Account (MCA).Goal The goal of the survey was to determine the prevalence alcohol consumption pattern among Mongolian adults using WHO-approved methods, and to inform on NCD and injury control activities.Objectives:To compare the current prevalence of alcohol consumption to that identified in the previous STEPS survey. Alcohol consumption patterns, frequency of drinking and risks associated with alcohol consumption will be studied according to gender, age and place of residence of the survey respondents.Materials and MethodsThe cross-sectional survey used WHO STEPS survey methodology adapted to the countries specifics. A total of 5638 randomly selected 15-64 year-old Mongolian residents of both sexes from 36 soums of 20 aimags and 6 districts of Ulaanbaatar city participated in the survey. The survey data was fully collected using small handheld computers (PDAs). Because the data was comprised of only a sample of the large population, it was necessary to weight the data, Thus sample weighting and adjustments to correct the differences in the age-sex distribution of the sample compared to the largest population were performed. Data analysis was conducted using EPI INFO version 3.5.1 using appropriate methods for the complex sample design of the survey. Outcome measures (prevalence and mean variance) and differences between groups (age, gender and urban\ rural groups) were calculated with 95% confidence intervals (95%).Results:34.2% of Mongolian adults did not use alcohol in their life-time and 65.8% of them used alcohol to some extent. The prevalence of binge drinking was 39.7% in men and 15.1% in women, and binge drinking was 2.5 times more common in males compared to females.

Since 1994 when Directly Observed Therapy Short Course (DOTS) was first introduced in TB control in Mongolia, the National TB Programme has made significant progress in detecting and curing TB. In 2007, we were able to detect 81% of all TB cases and cure 88%. However, we face many obstacles and challenges in dealing with drug-resistant tuberculosis including limited access to multi-drug resistant TB treatment, limited supply of second-line drugs, limited capacity of service providers, poor infection control in health facilities dealing with MDR-TB patients, limited financial resources. Since 2006 Mongolia has started to implement project on multi-drug resistant TB (MDR-TB) management through support of the Global Fund to Fight AIDS, Tuberculosis and Malaria. In total, 888 cases of drug-resistant TB were detected in our country. Among them, 66.3% (589) were diagnosed with MDR-TB. Among 589 MDR-TB cases diagnosed between 2003-2009, 45.3% (267) are enrolled in treatment, 26.7% (157) died before enrollment into treatment, 19.7% (116) are on waiting list. If we do not improve supply of second-line drugs we will continue to face obstacles in provision of medical services to MDR-TB patients. Our data shows that although MDR-TB cases were diagnosed in 2006, the number of patients who would not be able to receive the treatment and would die by 2015 would increase up to 510 persons. In other words, although about 70 patients are diagnosed every year, they would not be able to receive treatment. Mobilization of 350 thousand US dollars every year and advocacy among decision makers in order to improve their commitment will contribute to fight against MDR-TB in our country.

BACKGROUND: Acute myocardial infarction is leading cause of global morbidity and mortality and major health care burden in worldwide. Previous studies demonstrated that restoration of myocardial tissue perfusion after primary PCI is significant factor of improved outcome. In Mongolia, studying long term effects of primary PCI in patients with AMI and its’ association with coronary blood flow, tissue Doppler imaging, left ventricular global strain pattern in speckle-tracking echocardiography and risk factors are essential in theoretical and clinical practice. AIMS: To determine long term effects of primary PCI in patients with AMI and its’ association with left ventricular strain pattern in speckle-tracking echocardiography, risk factors and patient prognosis. METHODS: We used prospective cohort study design. We were selected 414 patients with AMI who treated by primary PCI between 2015 and 2016 at the State Third Central Hospital. Echocardiographic examination was conducted on Philips iE33 xMATRIX ultrasound machine. The PCI was performed according to the MNS:6379-2013 standard. RESULTS: Mean age was 60±13 and majority of them were male 84% (n=347). Complete coronary perfusion (TIMI-3) was achieved in patients 88% (n=367) after primary PCI. There was weak, negative correlation between coronary TIMI flow grade and left ventricular global longitudinal strain (r=-0.183, CI 95% -0.289 to-0.066, p<0.001). In patients with incomplete coronary perfusion (TIMI<3), mortality rate was significantly higher during 24 months follow-up. After primary PCI, 24 months mortality was 9.9% (n=39). Cut-off value of left ventricular global longitudinal strain which predict long term (within 24 month follow-up) mortality was -12.93% (sensitivity 74.4%, specificity 74.3%). Mortality during 24 months follow-up was significantly different between left ventricular global longitudinal strain groups (log-rank test p<0.001) and mortality was higher in left ventricular global longitudinal strain ≥ -12.93% group. CONCLUSION: Coronary no-reflow phenomenon is associated with long term mortality in patients with AMI. In patients with AMI who treated by PCI, long term mortality is predictable with left ventricular global longitudinal (≥-12.93%, p<0.001) strain.

IntroductionCardiovascular diseases are among the first three causes of mortality in the global population. 1 billion people in the world suffer from arterial hypertension2. In USA 60 million people have high arterial blood pressure, while 40% of the adult population of Russia have arterial hypertension. In Mongolia 28% of the adults suffer this disease. For most countries, arterial hypertension is both health and social problems. Studies of research centers in the USA and Western European countries demonstrate that decreasing the prevalence of arterial hypertension diseases can prolong the life expectancy3. There is an increasing trend of cardiovascular diseases in the Gobi region on Mongolia (10000:645.63 in Umnugobi aimag) with no tendency to decrease predicted in the near future4,5.ResultsWe conducted the study in order to define the intermediate risk factors causing the cardiovascular diseases on the aimag and soum levels. The study involved 754 people over the age of 30 years from 14 soums of 4 aimags. Of these participants, 26.3% are males and 73.7% are females. Our study shows high prevalence of arterial hypertension among the population, particularly among the working age population. A majority of the people over 30 years old taking park in our study had a low level of education, lower than minimum living standard income and unemployed. Among the people aged over 30 years, every fifth person uses tobacco and every seventh abuses alcohol and it shows that there is high index of alcohol and tobacco use among the population. 92.4% of the reviewed used less than 5 units of fruits and 90.8 of them used less than the same units of vegetables.ConclusionThus, the Gobi region population consumes insufficient quantity of fruits and vegetables with the entire food pattern being generally unhealthy. Hypodynamia is common among the population varying across the ages, sexes, occupation groups and locations. The average systolic and diastolic pressures are higher in men than in women. The prevalence of overweight and obesity is high due to lack of physical exercising, weight control and optimization of food intake. As to the genders, women have a higher risk for overweight. Blood cholesterol and triglyceride levels are higher in men. The correlation between arterial hypertension and consumption of alcohol and tobacco, obesity and overweight and hypodynamia is strong.

IntroductionIsolated systolic hypertension (ISH) has been found to increase the risk of stroke and coronary heart disease significantly among both middle-aged and elderly men and women. ISH is a higher risk factor for cardiovascular diseases (CVDs) than isolated diastolic hypertension. Because of this it is important to determine the prevalence of ISH and its associated risk factors in order to reduce CVD mortality and morbidity in Mongolia.ObjectivesThe aim of the study was to compare the physical activity of people with ISH to it of people with normal blood pressure (BP).Мaterials and MethodsWe examined the physical activity using the data of “Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease and Injury Risk Factors-2009”. ISH was defined as systolic BP≥140 mmHg and diastolic BP<90 mmHg. The Control (normotensive) group comprised subjects whose systolic BP<140 mmHg and diastolic BP<90 mmHg. Using to approach of WHO “STEPS” Survey, physical activity was assessed on intensity, duration and frequency of physical activity at work, in recreational settings and during transportation using complex set of 16 questions.ResultsAccording to the survey results, 74% of people who had normal BP and 48.7% of people with ISH engaged in moderate levels of physical activity in recreational settings daily a week. It was statistically difference in two groups. Males with ISH were more likely to engage in high levels of physical activity at work and in recreational settings compared to females. In terms of age differences, moderate and high levels of physical activity at work decreased steadily with age. Mean duration and frequency of physical activity a week weren”t difference in two groups.ConclusionFrequency of physical activity decreased with age in respondents with Isolated systolic hypertension. Males engaged more in high levels of physical activity at work and in recreational settings more than females. Moderate levels of physical activity in recreational settings was lower in respondents with ISH compared to respondents who had normal blood pressure (p<0.05).