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.

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.

BACKGROUND. To identify the prevalence of oral lesions in HIV positive group of patients, and to compare their CD4 cell count and viral load to stages of disease progress. MATERIAL AND METHODS. In the present study, we evaluated 30 HIV+ adult patients, attended to the AIDS/STI Department of National Center for Communicable Diseases, Ministry of Health Mongolia. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by Flow Cytometry, as well as viral load by RT-PCR (Amplicor HIV- RNA, TM test 1.5, Roche) RESULTS. 46% of all examined HIV/AIDS patients had oral lesions. Oral Candidiasis constituted the most common lesion, representing 35%, Herpes 22%, followed by Oral Leukoplakia 17%, Necrotizing ulcerative periodontitis 9%, Aphthous Recurrent Stomatitis 13%, Kaposi’s sarcoma 4%. The patients, who have a viral load high exhibited oral lesions related to HIV, independent of CD4 cell count, although patients with CD4+ levels of 233 cel/mm3 were more susceptible to develop these lesions. СONCLUSION. The most common oral lesion was Oral Candidiasis, followed by Oral Leukoplakia and Necrotizing ulcerative periodontitis. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+cell count..

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Healthcare is a rapidly growing industry as medical treatments become more sophisticated, more in demand due to increasing incidence of chronic disease and more widely available worldwide. As the amount of healthcare waste continues to increase, there is a need for further research in the field to meet the global demand for proper disposal of healthcare waste. The growing healthcare consumption, driven by various factors, is contributing to the rise in hospital waste, which in turn is putting pressure on current waste management systems.Currently, healthcare institutions manage waste by segregating at the source, safely transporting infectious waste, and disposing of it through incineration, autoclaving, or landfill methods. Both incineration and autoclaving processes have negative environmental and human health impacts. To reduce the amount of healthcare waste generated, it is necessary to train healthcare workers to properly segregate waste according to its type, following established standards.
Governments can take action to improve waste disposal practices, reduce the generation of infectious waste, and ensure that all types of healthcare waste are properly disposed of. This can include:
• Governments should have clear and standardized definitions for both infectious and non infectious healthcare waste, and enhance the regulatory and legal framework to prevent illegal disposal of waste.
• Healthcare institutions should be provided with incentives, financial support, and other measures to reduce hospital waste, with a particular focus on reducing infectious waste in local health institutions.
• Governments should provide research grants to support studies aimed at reducing and managing healthcare waste disposal effectively.
These measures would help improve the overall management and reduction of healthcare waste and ensure a safer and more sustainable approach to waste disposal.

ABSTRACT. Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.

Aphthae are common oral lesions that affect approximately 10% to 20% of the population. Recurrent Aphthous Ulcers (RAU) are usually classified into three different types: minor, major and herptiform RAU. The etiology of aphthous stomatitis is unknown but according to increasing evidence, its development has an immunogenic process that causes the ulceration of the involved oral mucosa. Similar-appearing lesions may arise in following systemic disorders: 1. Behcet’s disease 2. Sweet’s syndrome 3. Cyclic neutropenia 4. Benign familial neutropenia 5. MAGIC syndrome 6. A periodic syndrome with fever and pharyngitis 7. Various nutritional deficiencies with or without underlying gastrointestinal disorders Several studies from the UK, United States, and Spain have demonstrated that hematinic deficiency (iron, folic acid, or vitamin B12) are twice as common in RAS patients than incontrols. Case report: A 10 year old male patient presented a 3-year history of episodes of multiple minor recurrent Ulcers, this year major aphthae on the anterior ventral surface of the soft palate. Patient had difficulty in eating and in speech. Clinical examination revealed multiple symptomatic ulcers with a perilesional erythematous halo covered with a pseudomembrane. The size of major aphthae was than 20 mm in diameter. The ulcers were not associated with any type of discharge. The ulcers were tender on palpation. The medical history and the family history were non-contributory. A clinical diagnosis of major aphthous ulcers was made on the basis of the history and the clinical examinations. The patient was subjected to a therapeutic regimen consisting of daily topical application of Prednizoloni 0.05%, topical lidoksor and systemic vitamin and Cefatoxime Natrii, Immunomodulators Biferon, Amphotericin B. Recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) remains a common oral mucosal disorder in most communities of the world. Proper systemic evaluation is important before prescribing the medication.

65 Non-bacterial originated tooth wear is a normal process which occurs throughout lif. If the rate of loss is likely to prejudice the survival of the teeth, or is a source of concern to the patient, then it may be considered ‘pathological’. Robb reported that the prevalence of pathological loss of tooth tissue in patients less than 26 years of age was greater than in many older age groups. Tooth surface loss was classified into 4 groups: attrition, erosion, abfraction and abrasion. To find the prevalence of four different types of tooth wear among patients visited Digital Dental Office, Ulaanbaatar, Mongolia and investigate their dental attrition severity. Methods: From total of patients visited Digital Dental Office clinic between September 2016 and September 2017 adults aged 16-62 who was found with any type of tooth wear were explored by 4 types. Those patients with attrition were chosen and severity was determined by Bardsley’s simplified tooth wear index (TWI). There were total of 5432 patients examined and treated during this period of time. From them total of 1002 patients aged 16-62 presented some degree of tooth hard tissue wear/dental attrition. Most of the patients were with combination of 4 types of tooth wear: attrition, abrasion, abfraction and erosion. Attrition (At) was found in 68 patients which was only 6.7%, Abrasion (Ab) in14 people-1.3%, Abfraction (Abf) in 4-0.3%, Erosion (Er) in 2 -0.1% alone. The combination of these types of tooth hard tissue was dominant. At+ab+abf+er in 59 patients of total 1002 (5.8%). At+ab+er in 58 (5.7%). Ab+abf in 29 (2.8%). At+er in 25 patients (2.4%). Er+ab in 27 (2,6%). At+abf+er in 264 people (26.3%). At+abf in 452 (45.1%), which was the most prevalent combination. Dental attrition severity in these 1002 patients were shown as following: -0-0- No loss of contour. -1-229 people (22.8%) - Loos of enamel surface characteristics. Minimal loss of contour. -2- 505 people (50.3 %) - Loss of enamel exposing dentine for less than one third of surface.Loss of enamel just exposing dentine. Defect less than 1 mm deep. -3- 211 people (21 %) - Loss of enamel exposing dentine for more than one third of surface.Loss of enamel and substantial loss of dentine. Defect less than 1-2 mm deep. -4-57 people (5.6%) - Complete enamel loss - pulp exposure - secondary dentin exposure.Pulp exposure or exposure of secondary dentine. Defect more than 2mm deep - pulp exposure - secondary dentine exposure. In this descriptive study showed patients with some degree of tooth wear were around 19% from total patients visited during 1 year of period. Four types of tooth hard tissue wear shown as a different combination, very low percentage was in these types alone. Most of the attrition patients were with mild to moderate degree of enamel loss. This kind of study should be continued to explore harmful dentofacial change

BACKGROUND. Periodontal regeneration is the reconstruction of periodontal tissues and restoration of functions, which is achieved through techniques, such as soft tissue grafts, guided tissue regeneration, bone replacement grafts, root bio-modification, and a combination of these techniques. Chitosan is a natural biopolymer with several beneficial properties, including excellent biocompatibility, low toxicity and corresponding degradation rates and hemostatic activities. This systematic review assessed the efficacy of biopolymer membrane (chitosan) for guided tissue regeneration (GTR) in animal and human studies. MATERIAL AND METHODS. The Cochrane Oral Health Group specialist trials, PubMed, MEDLINE, and EMBASE databases were searched for articles published before January 2017. Animal and human studies that used chitosan for GTR, which had a follow-up period of ≥6 weeks and 6 months, respectively, were retrieved. The following outcomes were analyzed: new bone (NB) and new cementum (NC) formation for animal studies and probing pocket depth and clinical attachment level changes for human studies. RESULTS. After a full-text review,six animal studies and three human studies were found to be eligible for this study. All included animal and human studies demonstrated that the use of chitosan for GTR exerts a positive effect on periodontal defects. Subgrouping meta-analysis outcomes of three dog studies revealed that GTR with pure chitosan membranes has a positive effect on NB (14.36%) and NC (10.21%) formation. CONCLUSION. Within the limitations of the present study, there is little evidence to demonstrate the efficacy of chitosan for GTR either in animal or human studies. Chitosan should rather be used as an adjunct component for membrane production.