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.

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).

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.

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.

BACKGROUND. The aim of this study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI) and risk factors of stent restenosis. MATERIAL AND METHODS. We conducted a retrospective cohort study based on the Angiographic diagnostic and treatment Department of 3rd State Central Hospital of Mongolia. Patients who had undergone coronary stenting between 2000 and 2017 were recruited and monitored until the end of 2010. RESULTS. Among a total of 4520 selected patients with a mean age of 58±7 years, 2125 subjects had BMS and 2395 subjects had DES. The incidence of stent restenosis and stent thrombosis were significantly lower in the DES (37; 1,5%) group as compared with the BMS (201; 9,4%) group. Patients who have stent restenosis presented comorbidities, such as diabetes 214(47,8%), hypertension 54(22,6%), prior PCI 21(8,2%), re-infarction 12(5,04%), chronic kidney disease 16(6,7%), hyperlipidemia 21(8,2%). СONCLUSION. Implantation of DES was related to better outcomes than for BMS, in terms of reducing restenosis and stent thrombosis after PCI. STEMI patients who have co morbidities have greater risk of stent stenosis and thrombosis

Introduction: It has been found that morphological changes of elastic and elastic-muscular arteries wall are the main role in elevation of systolic blood pressure. Furthermore, Isolated systolic hypertension (ISH) has been found that to be associated with cerebral stroke, myocardial infarction and heart failure. And according to national study of prevalence of risk factors on non-communicable disease, it found that risk of CVDs (cardiovascular diseases) is a high among Mongolian and one fifth has more than 3 risk factors of atherosclerosis. The researchers found that atherosclerosis begins relative in young people and endothelial dysfunction is without clinical signs of CVD among Mongolian. Purpose : To determine the atherosclerotic changes and associated with some risk factors of subjects with Isolated systolic hypertension. Materials and Methods: We used hospital-based cross-sectional study design. Data collection was conducted using questionnaire, body measurement, and laboratory methods. A standardized questionnaire was used according to the methodology from the “STEPs” Survey on the prevalence of Non-communicable disease and injury risk factors, body weight, height and blood pressure were measured by standard method. Results : In group with ISH, maximal IMT of CCA was 1.46±0.44mm, systolic diameter was 5.89±0.68mm, diastolic diameter was 6.34±0.73mm respectively which were significantly higher than normotensive group (1.21±0.28mm, 5.58±0.59mm, 5.99±0.58mm) (p<0.05). Furthermore we studied plaques of carotid artery, and atherosclerotic plaques were revealed in 69.2 percent of subjects with ISH which was significantly higher compared with normotensive subjects (p=0.003). And resistive, pulsative and stiffness indexes were significantly higher in group with ISH which represents vascular resistance of CCA. But end-diastolic velocity of CCA significantly reduced in group with ISH (p=0.015). We found that atherosclerotic index increases every year by 6.5 percent, every one mm Hg of systolic blood pressure by 3.7 percent and every year of increasing blood pressure by 10.5 percent respectively. Conclusion
1. Atherosclerotic changes were revealed more in subjects with ISH compared to subjects with normotensive.
2. Advancing age, long duration of smoking, a high level of systolic blood pressure, having a high systolic blood pressure level for a long time and high consumption of salt intake are accelerating atherosclerotic changes of carotid artery.
3. According to increasing atherosclerotic change, blood stream velocity of carotid artery is decreasing and resistive and pulsative indexes are increasing.

Endometriosis is described as a chronic inflammatory disease, characterized by endometrial-like tissue, found outside the uterine cavity which cause chronic pelvic pain, infertility,dysmenorrhea. The prevalence of endometriosis is difficult to determine accurately but in asymptomatic women, the prevalence of endometriosis ranges from 2- 22 %, depending on the population studied , in infertile women 20-50 % and in those with pelvic pain, between 40-50% (Balasch, 1996; Eskenazi, 2001; Meuleman, 2009).Endometriosis is found 7-10% of reproductive agewomen and 20-90% in with chronic pelvic pain, infertility cases. Pathogenesis of endometriosis is not yet fully understood but one potential cause of the disease is retrograde menstruation which results in the deposition of endometrial tissue into the peritoneal cavity. Today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Susceptibility to endometriosis is thought to depend on the complex interaction of genetic, immunologic, hormonal and environmental factors. To determine prevalence and severity of clinical symptoms, compare meta-analysis to changes the clinical value of serum CA-125 and peritoneal fluid cytology in women with endometriosis of Ulaanbaatar city. We had selected total of 60 woman with endometriosis which were registered from January to December 2014 in gynecologic clinic of First Maternity Hospital. The research group registered in questionnaire with 28 questions. During the inspection laboratory analysis of serum CA-125, ultrasound analysis and peritoneal fluid cytology were done. Assessment of pelvic pain by means of a 10-point linear analog scale / pain score/ which provided by International Pain Association. The research result was worked out by prospective method. Average age of patients 33.4±8.9. Pain location: Chronic pelvic pain 30%; Dysmenorrhea 28.3%; Dysparunea 10%; Pain during defecation 6,7%; Without pain -25%. Average level of Serum СА125 was 38.13±20.6. Location of endometriosis: adenomyosis - 8.4%, endometrioma-15% endometriotic lesion at cul de suc 68.3%, rectal involment 1.7%, tubal lesion-3.3%, combined 3,3%. 76.7% of surgery for endometriosis have done by laparoscopy and 23.3% by laparotomy. Ultrasound examination result: endometrioma d=0-2cm-1.7%, d= 3-5cm-36.2%, d=6-8cm-10.3%, d=9cm<-12.1%. Cytology result: Peritoneal fluid contains 75% of erythrocytes, mesothelial cells and it needs to further study.CONCLUSION:Most of patient /58.3%/ had chronic pelvic pain and dysmenorrhea. The severity of pain was significantly improved after operative laparoscopy. /p<0.05%/51,7% of patient had infertility problem.Value of serum CA-125 was higher in study group with large sized and not clear content ovarian endometrioma by ultrasound examination. /p<0.05%/The local environment of peritoneal fluid surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, erythrocytes, eosinophils and mast cells. In our cytology results: peritoneal fluid contains 75% of erythrocytes, mesothelial cells.

Various studies conducted worldwide emphasized the importance of identifying gastric cancer risk factors for better prevention and further incidence reduction. A total of 52 identified risk factors for gastric cancer were classified into nine categories in which diet, lifestyle, and infections are leading causes. Gastric cancer morbidity and mortality has an increasing trend annually in our country. In Mongolia, only 1% is diagnosed in the carcinoma stage, 3% in the first stage, 11% in the second stage, 43% in the third stage, 42% in the fourth stage.
The “Gastric cancer risk factors study, 2018” by L.Tulgaa, and D.Ganchimeg confirmed smoking on an empty stomach as a risk factor. B.Gantuya et al`s (2018) study on gastric cancer and helicobacter infection, as well as S.Tsegmed et al`s (2012) gastric cancer prevalence, its risk factors study, had similar results.
B.Gantuya et al (2018) identified the excessive consumption of salt among the gastric cancer diagnosed population in Mongolia. Also, L.Tulgaa and D.Ganchimeg et al`s “Gastric cancer risk factors study, 2018” results reported the daily consumption of salt in tea is a risk for gastric cancer.
L.Tulgaa et al`s (2018) study participants had irregular mealtime such as dinners are at a very late hour, the meals aren`t chewed well, leftover meals, and seasoning consumption. These characteristics were significantly different in two groups with a statistically important result.
Furthermore, the study results suggested a need to provide practical advice on healthy eating to the population as 50% of the participants consumed more than 5 high-risk food products for esophageal and gastric cancer along with combined risk factors.

Introduction: Beginning 15 May 2019, the consumption of raw coal in Ulaanbaatar has been replaced by the consumption of briquette fuel for the improvement of air quality according to Governmental Resolution No.62 adopted in 2018. Since after this resolution has been in placed the number of CO poisoning has been increased as of 18 December 2019, nine persons were died and 1394 people get a health care service due to CO poisoning. However, it has been not been assessed briquette affect to the indoor air quality and its health impact. Thus, it is need urge to define the indoor air quality effect of briquette and its heath impact. Goal: To assess the indoor air quality of the household using the “improved briquette” and identify the causes of the risk. Material and Method: This a cross-sectional survey, conducted from January 31, 2020 to April 31, 2020, data were obtained by quantitative, qualitative (observation, interview) and direct indoor air quality measurement. The survey sampling frame was 40 households in central 6 districts of Ulaanbaatar that used improved fuels (20 households with a history of carbon monoxide poisoning and 20 households that were not affected), and 14 households in the Nalaikh district that used raw coal, in total of 54 households were participated. Indoor air quality was measured by PM2.5, PM10, CO, SO2, NO2, and microclimate per household for 24 hours during a week.
The statistical data analysis was done by the SPSS-23 program and preformed required parametric and non-parametric tests. The normality of the data was checked by the Kolmogorov-Smirnov test. The most of data was not normally distributed. So, thus we used median and used relevant non-parametric tests. The average level of microclimate indicators, and air quality indicators were defined as mean, median and its IQR and standard deviation. The 95% confidence intervals of mean and frequencies were determined and used to differentiate group differences.
The Ethical permission to start the survey was approved by the 2nd meeting of the Ministry of Health on February 4, 2020. The committee was reviewed and approved the research methodology based on whether data collection technique and tools are considered the ethical issues, and whether provided accurate information for make decisions to enroll to the survey for respondents. Results: According to the health statistic, from October 2, 2019 to March 31, 2020, a total of 2,768 people from 837 households were exposed to carbon monoxide poisoning. Of the total reported cases, 10 were drunk, and 2 were due to other disease complications, and a total of 2,756 cases were confirmed diagnosis as carbon monoxide poisoning.
Emissions of CO were recorded every 15 seconds and the results were calculated by conducting continuous measurements per household for 24 hours a week. The level of CO emitted into the indoor environment of households exposed by carbon monoxide had increased during the following time from 7 am to 9 am in the morning, from 13 pm to 15 pm, from 18 pm to 20 pm in the evening, and from 22 pm to 24 pm at night. During this period of time, the indoor air CO level had increased from the WHO mild poisoning recommendation level. Conclusion It has been defined that the carbon monoxide emits to the indoor air households which are using an improved fuel according to measurement the 30 minutes, 31-60 minutes, and 61-120 minutes after burning.