Based on registered cases Н1N1 virus Influenza in Mexico, 26 April, 2009, there were done risk assessment of current and future situations in area along railway across Mongolia. In the frame of this work were done organizational work preparation, urgent activities to prevent the infection The result of this risk assessment were passed this situation with less risk and related activities were done by steps.Work of Making Sure of ReadinessBy the order number 22b of Vice Chairperson of the Security Departure of Railway, on 28th of April, based on act number 02 of the National Emergency Department, group of agents had been assigned on UBRW, on 6th of May ‘’Plan to Prevent and Making Sure Quick Response is Ready from H1N1 Virus Influenza Infection’’ had been declared, announcing to manage works to prevent new virus infections, enforcing presence of related laws and regulations as a duty, organized video-selector of railway on 12th of May 2009, by presenting ways to get infected, prevention, UBRW’s all departments, branches and agencies have organized to prevent. On 29th of June 2009, we have processed and announced a guideline to act when a ‘’Passenger that is suspected with Influenza virus’’, and we made sure international and domestic rails are ready. On 29th of July, with the help of National Infectious Disease Center, we have organized a training to ‘’Early Prevention from H1N1 Virus Influenza Infection Counteract and Preparing Readiness’’ with having presenters from hospitals like Central and Branch rails joint clinic, physicians from branches and factory clinics, Wagon Depo in Ulaanbaatar, Passenger Service Ulaanbaatar Central Station, and produced 63 trainers.In Work of Making Sure of Readiness, on 10th of September 2009, by the order number 50 of Chairperson of Railway, solved 43 million tugrugs of Investment to making sure readiness of the medical and passenger service, saved some protection materials and other inventories. During the red alert additionally planned 156 million tugrugs, during whole phase of H1N1 virus infection UBRW had spent 204 million tugrugs. When looking at the spending: Medical equipments: 73781076 tugrugs, sterilizations and disinfectants: 23907969 tugrugs, protection materials: 27230300 tugrugs, vitamins: 62511518 tugrugs, educational advertisements: 10672525 tugrugs, others: 3369620 tugrugs.Conclusion:1. Incidents of H1N1 virus infection of people in covering area of UBRW’s Central Clinic and its branches railway’s joint clinics are less than National, Ulaanbaatar City, and Provinces that have railways.2. Children ages ranging from 0 to 4 and people from 20 to 49 years old with full ability to work are more likely to get infected.3. According to the research H1N1 Influenza virus incidents are higher in Bayangol and Bayanzurkh districts. The most incidents, which are registered from Bayanzurkh district’s sub districts, are I, III, IV are higher than other sub districts. In these sub districts, Ulaanbaatar Central Railway Station, and commercial centers like BARS Food Market and TOSA Market are located. Moreover 49% of the infected people live in apartments in which they don’t have central how water system, which cannot be denied that, had affected the spread of infections. 4. 96.5-99.15 of all infected people had headache, dry coughing, sneezing, discomfort, chest pain; 76.95 of all children had symptoms like diarrhea. Most patient’s chest X-ray diagnosed one of the two lungs have pneumonia. 60% of all the children and adult from 50 and over had a history of pain and diseases. But youths from 20-49 didn’t have any history of pain and diseases.5. It was effective to use medication tactics like immune activator and anti viral medications.6. In UBRW’s range there haven’t recorded any incidents that are more than 2 people from work place, school and family.7. To conclude (didn’t get laboratory test) from the first registered and dead patient first contaminated 1 person, which had treated in National Infectious Disease Center. And 1 person got lightly sick and got treated at home. If the patient got sick seriously and diagnosed positive, the closest 1 to 2 people have a possibility to be very likely to get contaminated.8. The latency stage of infection was 1 to 3 days and the average inpatient days were 10 days.

The oral hygiene is not relatively good cause of smoking, ignoring oral hygiene, not having enough self-care skills and independent living in case mental illness. Their grinding the teeth, serotonin decreases when the people are depressed and then it makes the carbohydrates increases, loses the sense of taste. Therefore they use a lot of sweet, the salivary output decreases, increase in the number of lactobacili and then it makes the cause ofabnormal disease detections including tooth decay, trigeminus neural pain in temporomandibular joint /TMJ/, oral yeast infection, oral bad breath, burning sensation of the tongue, chronic facial pain. Also the oral can disease detects from drug causes like using the anti-depression drugs for at least 6 months.Using analytical research permanent design, I got 55 patients to take part in the survey who are staying in 5th flat , National Clinic of Mental Health from 22nd of September 2014 until 26th of September. When I do the research for history of their patients: among the diagnosis of 16 people disorder depressed, the 13 patients agreed to have a preventive examination voluntary, one of them declined to do it. I use many methods of researching like questionnaire methods interview method, prevention oforal cavity and clinical examinations, respectively Study shows that curriculum contents of School of Nursing, Mongolian National University of Medical Sciences have comparatively less contents of understanding about healthy person, assessment on human, giving advice healthy human, path anatomy, physiology, communication skills.The most of the survey participant patients have holes in their teeth, gum inflammation, and tongue stress disorder. It shows that it decreased to pay attention on their oral hygiene associated with symptoms and it effects directly related to the decrease in salivary output.Depressed People are so bad at paying attention to their oral hygiene habits.

INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.

INTRODUCTION:Waterborne diseases, especially diarrhea, related to water quality and safety, personal sanitation and hygienehave been still reported very high in developing countries. Globally, there are an estimated 1.4 million casesof hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and wateror through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poorsanitation [2].Dysentery is bloody diarrhea, i.e. any diarrheal episode in which the loose or watery stools contain visiblered blood. Dysentery is most often caused byShigella species (bacillary dysentery) or Entamoeba histolytica(amoebic dysentery) [3].Kharaa and Orkhon River are tributaries of the Selenge River-basin, in which many mining and other industries,agriculture, and residential areas reside. It has become a one pollutant factor for water of the Kharaa andOrkhon rivers. As a result, water of the Tuul, Kharaa and Orkhon River was reported to be highly contaminated(Mongolian Human Development Report 2010: Water and Development report) [4].GOAL:The aim of the research was to study incidence of gastrointestinal infectious diseases among population ofsoums are located in Selenge River Basin.MATERIALS AND METHODS:Data on health statistics 2009-2013 years of gastrointestinal infectious diseases, including dysentery, diarrhea,hepatitis A virus and others, were collected and analyzed.RESULTS:Incidence of dysentery was registered highly among people who live in Mandal soums in 2009-2013 years. Butincidence of dysentery (per 10 000 population 2.82) among population ofMandal soum lower than the Selengeprovince and National average. Incidence of hepatitis A virus was registered highly among people who livein Orkhon (74.46), Orkhontuul (48.86) soums and it was greater than 1.3-2 times than the Selenge provinceaverage. Incidence of diarrhea was registered highly among people who live in Khushaat soum and it wasgreater than 2.18-3.8 times the than Selenge province averageCONCLUSION:Incidences of diarrhea and hepatitis A virus were registered highly in Orkhon, Orkhotuul and Khushaat soumscompared to other target soums and it was greater than 1.3-3.8 times than the Selenge province average.Especially, these diseases were registered highly among 0-16 aged children.

Introduction: This article provides areview about techniques and pitfalls of arterialand venous reconstruction during kidneytransplantation. Main reasons of our clinicalstudy are to evaluate vascular variationsof kidney, posttransplantation vascularcomplication incidence and present status ofsurgery outcome.This retrospective researchbased on cross-sectional assessmentofconsecutive 102 kidney transplantation cases,which performed from 2006 to 2015 at theFirst Central Hospital of Mongolia.Materials and methods: Statisticalprocessing andanalysis on posttransplantionpatient history data are made byMicrosoftExcel, SPSS19.0software.Results: Despite rising technicaldifficulties caused by vascular variations,pelvic and inguinal morphology of recipientand the existence of multiple renal arterieskidney transplantation is a safe and highlyefficient procedure.On this article wereexplained 44 kidney transplantation caseswith reconstruction using microvasculartechniques to reconstruct renal arteriesand veins. About 10 different kinds ofreconstructions were done in our practice.Due to investigation of consecutive 102kidney transplanted recipients, 24,51% had avascular anatomical variations. And describedabout 44 vascular reconstructions used inour hospital in case of vascular variations.According to the lit., vascular complicationsranges from 1 to 16%. In our hospital,vascularcomplication of kidney transplantation withmultiple vessels is 4,0-12,0%. Also, incidenceof vascular complication in group with singlevessels from 1.3 to 2.6% and in group withmultiple vessel 4 to 12%.Even it is highcomparing with other international articles;it’s almost in same results. But lymphaticcomplication is higher than others; it showsneeds of careful and accurate dissection ofrecipient site anastomosing vessels.Conclusion: Multiple renal graft’sveselshave been associated with a higher rateof vascular complications, including arterialstenosis and lymphorrhea. It shows needs ofcareful and accurate dissection of recipientsite anastomosing vessels.

Introduction: Air pollution is one of the greatest environmental risk to health. Ambient air pollution accounts for an estimated 4.2 million deaths per year due to stroke, heart disease, lung cancer and chronic respiratory diseases. Approximately 46% of the population resides in Ulaanbaatar, and over half of the population living in ger (traditional yurt dwelling) areas consumes raw coal, which leads to an increase in ambient air pollutants. The Government of Mongolia took a series of actions to reduce air pollution; one was the ban on the consumption of raw coal beginning on 15 May 2019. The aim of this study is to describe the Ulaanbaatar air quality related to briquettes usage during cold seasons. Material and Methods: We used ecological research design in this study. Quantitative data about air quality of Ulaanbaatar city during the cold seasons (Oct, Nov, Dec, Jan, Feb, Mar, Apr) in 2018-2020 years were analyzed from Department of air quality. These 5 indicators such as sulfur dioxide, nitrogen dioxide, particles (PM_2.5, PM₁₀) and carbon monoxide were selected for statistical analysis. The SPSS-20 software was used to analyze the data. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on 5^th of February, 2021. Results: The average sulfur dioxide, nitrogen dioxide concentrations in the air have increased in October 2019–April 2020 compared to the previous five years. But carbon oxide, particular matter concentrations have decreased in the selected years. Sulfur dioxide (p <0.0001), nitrogen dioxide (p =0.001), PM₁₀(p <0.0001), and PM_2.5 (p <0.0001) are differentiated before and after the use of improved fuels by Wilcoxon signed rank test. However, the CO content did not differ from that of the briquette’s consumption (p =0.412). Conclusions During the cold seasons, the concentration of sulfur dioxide and nitrogen dioxide has increased in air of Ulaanbaatar after used briquettes, while the concentration of particulate matter has decreased during the cold seasons.

Introduction: Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change, so we consider to chose to study this topic. Aim: In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result: The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was 1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia 3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%, 5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study. Conclusions In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa), sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods is equally effective for resection of colon pollyps up to 1 cm in size.

BackgroundHuman-induced climate change will affect the lives of most populations in the next decade and beyond. The impact of meteorological conditions on human health has been reported globally. There is a need to conduct surveys for correlation between climate change and human health.GoalTo study the impact of air temperature on human health in selected aimags and city districts.Materials and MethodsIn order to study how climate change and air quality parameters affect human health we selected Zavhan, Selenge, Dornod, and Umnugobi aimags which represent different climate zones and 2 districts of Ulaanbaatar city during 2009-2011. All data for respiratory system disease J00-J99, circulatory system disease I00-I99, were collected from soum, district’s hospital, and aimag and soum’s Department of health.ResultsDuring the study period, a total number of 8649 incidences of respiratory disease are registered. From them 74.2 percent are influenza and pneumonia (J09-J18), 17.6 percent are other acute lower respiratory infections (J20- J22), and 8.2 percent are asthma (J45-J45.9). For cardiovascular disease 15288 incidences are registered. From them 65.6 percent are hypertensive disease (I10-I15), 23.6 percent are ischemic heart disease, and 10.8 percent are cerebrovascular diseases (I60-I69). The lower the air temperature, higher the incidence of influenza and pneumonia, acute lower respiratory infections, hypertensive, and ischemic heart disease.ConclusionsCold weather is correlated with a higher incidence of respiratory and cardiovascular diseases.

Background:However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant ensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens.Objective:Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients.Material and Methods:We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two year serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings.Results:The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups.Conclusion:A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.

Introduction: Among the population of Mongolia, cardiovascular diseases (34.2%), cancer (24.3%), accidents and external causes (16.9%) are highly prevalent, and risk factors such as alcohol and tobacco use, unhealthy diet, lack of exercise have increased dramatically, and more than half of people aged 45-64, or 53.2% are at high risk of contracting non-communicable diseases. When comparing the demand for health care and services according to the level of healthcare institutions, it was determined that 70% of the demand is in the primary healthcare institution, 20% at the secondary level, and 10% at the tertiary level. Therefore, in order to prevent these diseases and provide health education to the population, it is necessary to study the attitude of the citizens who visit primary healthcare institutions about public health care and services. Material and Methods: In this study, a cross-sectional research design was used to determine citizens’ attitudes toward public health care and services. In collecting data, a total of 291 people from each of Dornod and Khovd provinces, from the capital of provinces, and 3 soums were included in the target sampling method. When evaluating the attitudes of the respondents, they were rated on a scale of 1-5 for each question. The SPSS-20 software was used to analyze the data. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on the 30th of June, 2022 (Decision #22/05/04). Results: 51% (148) of respondents rated their health status as good and 42.1% (122) rated it as moderate, and 57.6% (167) of all respondents answered that they visit the primary health center when they have symptoms. Also, the status of visiting a primary health center for prevention is better in the following groups: 45-54 age group, among people with complete secondary and higher education, and soum healthcare center.
The attitudes of the participants towards public health care and services were evaluated in 4 groups, which are the demand for organizing preventive measures, the dependence of health on the individual, and the dependence of health on social and economic conditions, with an average of 4 points which means the demand is great. In addition, the healthcare institution’s organization of measures to promote and prevent the health of citizens is an average of 3.87 points, and the general score of the respondents’ attitude is 3.98 points, which indicates that there is a great demand for public health care and services. Conclusions Despite the low number of visits to primary health centers for preventive purposes among the respondents, attitudes toward public health care and services were good.