Objective. The aim of this study was to evaluate tooth loss prevalence, denture types and prosthetic dental treatment needs among people of ages 35-44 of Bayangol District of Ulaanbaatar City. Materials and Methods 9351 subjects were examined and questionnaires were presented to partially and/ or totally edentulous subjects among patients of this research. The questionnaire consisted of questions; age, gender, education level, place of residence, problems with dentures, necessity for new denture. Results. Most of the people were partially edentulous (93.0%) and 6.0% was full dentate, 1.0% was complete edentulous. In this research, only 6% of the people are full dentate but 94.3% have missing teeth and it indicates that the most of the people are demanding partial denture treatment. Acrilic denture was consumed in (3159) 95.0% of total dental coverage, but only 116 people had fixed denture. Acrylic denture was consumed much more than removable partial denture and bridge, and it may be due to expensive price of bridge and implant. The number of female patients with complete dentures was more than the number of males, with opposing trend for partial dentures. Tooth loss is a major indicator of oral health among adults, which may be increased by the lack of access to care, certain chronic diseases and/or insurance status. Conclusions. Almost 940 people in each 1000 people of ages 35-44 or 9 of every 10 subjects of among patients of Bayangol District, Ulaanbaatar City have edentulism /р>0.001/. It has been estimated that 34.5% about adults of those with edentulism had prosthetic treatment and majority (95%) of them use acrylic denture. We can see that 94.3% of subjects among the patients of ages 35-44 in our research have had missing teeth and 60% of them had no any treatment and are demanding prosthetic treatment.

Introduction: Leading cause of mortality was cardiovascular disease alone last two decade and occurs5500-6000 deaths annually in Mongolia. Familial hypercholesterolemia is the most common inheritedmetabolic disorders and is characterized by severely elevated LDL-cholesterol levels. The prevalenceof the heterozygous state has been estimated at 1 in 200 to 1 in 500 and of the homozygous state from1 in 160,000 to 1 in 1,000, 000.Goal: To identify Heterozygous Familial hypercholesterolemia among the patients with cardiovasculardisease and study clinical features.Materials and Methods: After view medical examination patients with coronary heart disease andcerebral vascular disease, we selected 183 patients among 26 family who possible to have HeterozygousFamilial hypercholesterolemia. We analyzed family history, clinical examination and lipid parameters.And identifi ed Heterozygous Familial hypercholesterolemia by diagnostic criteria of Netherlands.Results: The mean age for males was 42.3±14, for females was 45.8±15 and gender distribution was42.6% (78) male, 57.4% (105) female. Hypertension occurred in 80.9% (148). BMI was increasedwith age in both sexes (P<0.001). The frequency of tendon xanthoma was 26.8% (49) and cornealarcus was 36.6% (67). The level of total cholesterol and LDL-C were signifi cantly elevated in patients.Identity Heterozygous Familial hypercholesterolemia by criteria of Netherlands was certain-36.1%,probable-42.6%, possible-18.6%, unlikely FH-2.7%.Conclusion: Identifi cation of these individuals at an early age and an aggressive treatment of all knownrisk factors are important for reduce mortality of cardiovascular disease. The Netherland’s criteria issuitable for diagnosing Familial hypercholesterolemia in the Mongolian population, although it does notdiagnose the condition at the genetic level.

Introduction: The theory that usingmobile bearing (MB) design for total kneereplacementsurgeries can reduce the riskof tibial component loosening compared tofixed-bearing (FB) designs is still unclear.Arthroplastic surgeries developed rapidlywithin recent 10 years, but there is no similarstudy performed yet. This randomized studyinvestigated the impact of prosthesis design toloosening of components at 2 years for totalknee replacement surgeries.Materials and Methods: 479 patientswho underwent total knee arthroplastyin FirstCentral Hospital of Mongolia were allocated toeither FB or MB tibialarticulation.We comparedour results to similar studies which performedabroad due to there is no such a studyperformed before in Mongolia.Results: There is no significant differenceby age, sex, weight, height, body mass index,operation side (right or left) in both groups.Pre- and postoperative range of motionwasalmostsame for MB and FB groups.Butloosening complication was higher for the FBgroup (1.16%) than MB group (0%).Conclusion: Using MB design for total kneearthroplasty has less loosening complicationthan using FB design in Mongolians. Bonemineral density (dual energy absorptiometry)and radiostereometric analysis are necessaryfor widening studies in field of total kneereplacement surgeries in the future.

Introduction:Cardiovascular disease morbidity has been continuously increased among the population of Khangai region in the last 10 years - as of year 2010 for instance the rate was 1.5 more in Arkhangai aimag and 1.2 more in Khuvsgul aimag compared to the average rate nationwide. This research study was conducted due to the higher rates listed above in the region and the need to clarify various issues related to the medical care being provided with respect to the illness.Goal:It was deemed necessary to analyze the existing situation of early detection, monitoring and treatment of arterial hypertension among the population of the chosen province and to develop improved methodology.Objectives:1. To study the early detection of arterial hypertension2. To examine whether or not the clients are being given the needed recommendations related to the arterial hypertension monitoring and medicine treatmentMaterials and Methods:Cross sectional, organization based survey with 52 questions was carried out among 87 doctors/professionals of 17 soum and 100 family and aimag's general hospital of Orkhon, Bulgan, Arkhangai, Huvsgul and Selenge aimag. SPSS-17 program and Fisher test was used to generate and develop information.Results:Each soum, inter - soum and provincial doctor is responsible for checking/measuring the arterial pressure of their respective registered number of population by the percentage listed below: Soum doctor-56%, inter-soum doctor-50%, aimag's doctor-46,9% (p=0.19). Body weight and height are being irregularly measured on each chosen level (52.9%-62.5% p=0.67). Similarly the BMI is also being irregularly determined (42, 9% - 54, 5% p=0.07).From all the patients who have an arterial hypertension, 54.3%-55.6% are being monitored by dispensary and 11.1%-14.3% (p=0.53) are being regularly monitored in the chosen medical organizations. Although it is required to repeatedly measure and monitor the arterial pressure depending on its level the result shows that no planned monitoring is being done for the 77.8% of the patients. It is not sufficient for a sound and family doctor to recommend the regular use of antihypertensive the 48.6%, inter- sound doctor 43% and aimer's doctor 29% ( p= 0.40).Conclusions:1. The arterial hypertension - early detection practice is shown to be inadequate at the Chosen health care level (p=0.19).2. For the most clients with the arterial hypertension (59.9% p= 0.40), recommendations on regularly using antihypertensive is not being done - half the clients (54.3% - 55.6%) with the arterial hypertension are not being monitored.

BackgroundHealth professional licensing was introduced in Mongolia in 1999. Medical school graduates shouldpass the health professional licensing exam (HPLE) to be registered. It was informed that HPLEsuccess rate has been decreased for last few years among graduates who passed final theoreticexam (FTE). There has been no research conducted to explain the reasons of such trend. Thisresearch aims to conduct a comparative assessment of MSQs used for both HPLE and FTE.GoalTo analyze examination and test to identify the level of medical knowledge of students who graduateas medical doctor at “Ach” Medical University during 2011- 2015.Materials and MethodsThis is a cross sectional descriptive study. it employed a statistical analysis of 2950 MSQs (24version) that were used for the HPLE by the Health Development Center of the MOH (N=16)and FTE by the “Ach” Medical University (N=8) between 2011 and 2015. Test sheets of HPLE(N=728) and FTE (N=686) were assessed in order to identify a reliability of tests, difficulty index,discrimination index using QuickSCORE II program of the test reading machine with a mode of“Scantron ES-2010”.ResultsThe success rate was much higher in FTE than it in HPLE between 2011 and 2015. The successrate of HPLE decreased dramatically starting from 2013 (87%) to 2014 (4%) and 2015 (24%) whilethe same rate of FTE was stable and almost 100%.FTE’s reliability coefficient of 2011-2015 years meets requirement when it’s 0.92-0.96. HPLE’sreliability coefficient of 2013 and 2014 years don’t meet requirement.From all of the MCQs that has been used in FTE‘s 97% and in HPLE’s 80% are positive discriminationindex which means possible to identify medical school graduates knowledge.ConclusionOur findings confirmed that the success rates of HPLE among medical school graduates are beingquite low.Reliability coefficient of HPLE tests were less reliable (КР20=0.66-0.86) than FTE (КР20=0,92-0.96) and particularly tests for 2014 and 2015 were more difficult and were with high percentage ofnegative discrimination.Test score between HPLE and FTE of 2011-2015 is direct linear correlation.

Background and Purpose Liver disease that caused by iron metabolism failure is called Hemochromatosis (clinically “Bronze diabetes”, “Over spotted liver cirrhosis”). The two types of hemochromatosis are primary and secondary. Primary hemochromatosis is caused by a defect in the genes that control how much iron the human body absorb from food. Secondary hemochromatosis usually is the result of another disease or condition that causes iron overload. According to the study there is a real need to study the clinical reveals of hemachromatosis in Mongolian patients. The purpose of the study to determine the hemachromatosis in patients with liver cirrhosis and cancer.Methods and Materials: The study involved 68 patients with diagnosis Liver cirrhosis and HCC (1st stage) who were hospitalized in Clinic of Gastroenterology of Shastin clinical hospital and “Shagdarsuren” Hepatic hospital from April to July, 2011. All patients were increased blood iron and iron compounded proteins (ferritin, transferrin). DNA analyze have made in Molecular Biological Laboratory of Institute of Biology, Mongolia. Sequencing assay has made in Molecular Biological Laboratory of Humboldt University, Germany.Results. The patient’s age was 25-86, the mid aging – 55.42±1.7. The allele frequencies of the C282Y, H63D, and S65C mutation (which in chromosome 6) were 16/136, 11.7% (heterozygous 7, homozygous 2), 9/136, 6.6% (heterozygous 0, homozygous 9), 3/136, 2.2% (heterozygous 0, homozygous 3), equally 28/136, 20.5% (heterozygous 7, homozygous 14). Conclusions. In conclusion, the occurrence of the C282Y, H63D, and S65C mutation within HFE in this studied cohort of hereditary hemochromatosis. Therefore, these data incline that other factors than the HFE gene may play a role in determining hereditary hemochromatosis in Mongolians.

BackgroundClimate change, as defined by the United Nations Convention on Climate Change, is a “Change of climate which is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and is observed over time”. In 2001 an Initial Communication on Climate Change was prepared by the Government as part of its obligations under the UNFCCC. One of its recommendations was for “creating public awareness among a wide range of stakeholders including public, private and community sector organizations”. GoalThe main goal of the study was to develop recommendations and measures on prevention from diseases and adaptation to climate change by assessing knowledge, attitude and practice (KAP) of population towards climate change. Based on the main goal the following objectives were setup. Therefore addressing the different levels of knowledge and types of attitudes and practices people have towards climate change must initially be dealt with at the local level where site specific variations can be accounted for. Once research has been undertaken at the local level it can later inform decisions and policy at the regional, continental and global levels on how to incorporate site specific variations with in the greater context of the global threat.Objectives:1. To determine knowledge and attitude of population towards climate change;2. To determine practice of population on some adverse consequences of climate change;3. To develop recommendations and measures on prevention from and adaptation to climate change;Materials and MethodsThe study was at once carried out by means of questionnaire. In order to assess KAP of population, the data was collected using a card with 38 questions in three chapters which previously produced and ratified. The questionnaire was structured into 4 sections; demographics, knowledge, attitudes and practices. Two sums in an aimag from each climate zone of Mongolia were selected. In total, 2258 respondents aged 15 to 64 were involved from eight sums in four aimags (Zavkhan, Selenge, Dornod and Umnugovi), and two districts in Ulaanbaatar. The study data was input to computer using EPIDATA-3.6 software and statistically analyzed using SPSS-18.0 software.ResultsA total of 2258 individuals were interviewed. 44.1% 44.1% (995) of the participants was residents of Ulaanbaatar city and remained percentages accounted for residents living in the center of aimags and soums. 56.7% (1281) of participants were women and 43.3% (977) were men aged with 35.2±15.1 in average. Most of the study participants had educated with medium level (34.8%) and high level (30.0%). Employment percentage is 47.5% (1073). However, most respondents interpreted the meaning of climate change as “a change in weather,” “a change in normal climate conditions,” or “a change in temperature” – answers that requires more common sense than climate change savvy. Global warming is one of the evident of climate change. To know study participants awareness about climate change we used terminology of global warming. 25.3% (571) of the total participants answered that climate change revealed by the overheating or warming earth surface. 42.4% of the respondents answered the climate change could affect to health, 33.2% to environment and 16.3% to economy. 84.5% (1908) of the study participants agreed with that climate change has been started. Most of them (71.3%, 1824) allowed that people’s improper use of nature tend to global warming. When ranging the protection practices during the strong storm means of timbering the houses or gers accounted for 42.5% (960). Study participants supported the following activities; 41.2% (931) agreed that is it necessary to increase health services and 34.1% (769) suggested that it is better to enhance training and propagation for increasing awareness of population about climate change adaptation procedures and some information on climate changes and protection events. 85.2% (1923) of the study participants answered that they want to get the information on climate change from public TV.ConclusionsAlthough knowledge on global warming as the climate change was poor among the respondents, they agreed the climate change has already been started worldwide as well as in Mongolia. Only half of the respondents have had practice to prevent themselves from natural disaster.

Background and purpose: Liver disease that caused by iron metabolism failure is called Hemochromatosis (clinically "Bronze diabetes", "Over spotted liver cirrhosis"). The two types of hemochromatosis are primary and secondary. Primary hemochromatosis is caused by a defect in the genes that control how much iron the human body absorb from food. Secondary hemochromatosis usually is the result of another disease or condition that causes iron overload. According to the study there is a real need to study the clinical reveals of hemachromatosis in Mongolian patients. The purpose of the study to determine the hemachromatosis in patients with liver cirrhosis and cancer.Materials and Methods: The study involved 50 patients with diagnosis liver cirrhosis and cancer (1st stage) who were hospitalized in Clinic of gastroenterology of Shastin clinical hospital and "Shagdarsuren" hepatic hospital from April to July, 2011. The special questionnaire was used in the study. The biochemical laboratory examinations were taken and analyzed in lab "MED ANALYTIC". Biochemical tests performed on HumaStar 80 fully automatic analyzer. Determination of Iron level was performed by Photometric colorimetric test for iron with lipid clearing factor (normality 37-148ug/dl), transferring level by Turbidimetric monoreagent for the quantitative determination of transferring (normality 170-340ug/dl), glucose level by (GOD-PAP method) Enzymatic colorimetric test for glucose method without Deproteinisation (normality 75-115ug/dl). The ferritin level performed by ELISA analyzer (normality 15-240ng/ml).Results: The patient's age was 25-86, the mid aging-55.42. From all patients (29 male and 21 female) who were participated in the study, the 25 were with diagnosis liver cirrhosis and 18 of them clinically has the Child Pugh "B" cirrhosis, 7 has Child Pugh "A". The other 25 patients were with diagnosis liver cancer first stage.According to biochemical analyzes iron (n=35;70%); ferritin (n=41;82%); transferring (n=27; 54%); sugar (n=21;42%) levels were elevated.During the liver disease caused by iron overloading the following clinical symptoms were observed:- Skin spotting, n=48 (98%)- Hepatomegaly, n=33 (66%)- Splenomegaly, n=28 (56%)- Diabetes mellitus symptoms, n= 30 (60%)- Cardiovascular disease, n=16 (32%)- Respiratory system disorders, n=11 (22%)- Gonadotrophy, n= 2 (4%)The average serum iron level in case of livercirrhosis was 189.84+18.5mg/dl, in liver cancer 160.4±13.91 mg/ dl, ferritin level in case of liver cirrhosis was 407.69+50.08ng/ml, transferrin 375.68±47.38mg/dl, glucose 121.1±7.15mg/dl, ferritin level in liver cancer was 391.67±47.79ng/ml, transferring 388.76±47.38mg/dl, glucose 114.59±5.78mg/dl.

Introduction The rate of global warming has accelerated over the past 50 years, with 2014 and 2015 being the earth’s warmest years on record. The prevailing scientific view is that increased ambient temperatures are changing rainfall patterns and cause extreme weather conditions. Increasing surface temperature is melting glaciers and raising the sea level. More flooding, droughts, hurricanes, and heat waves are being reported. Accelerated changes in climate are already affecting human health, in part by altering the epidemiology of climate-sensitive pathogens.
Annually, one out of every four deaths worldwide is due to environmental pollution and climate change-related diseases.
Greenhouse gases from human activities are the most significant driver of observed climate change since the mid-20th century.
These warming trends may have profound effects not only on the environment but also on human health directly and indirectly. In fact, climate change has been considered the biggest threat to global health in the 21st century.

Background: Headache is a common disorder among population. 47% of population of the world suffers from the primary headache. Due to the chronic lasting process of headaches, individuals lose productivity, get depression because of negative impact on people’s quality of life and economic status.
Headache disorders are amongst the top ten causes of disability in Europe [4]. Three of these (migraine, tension-type headache and medication-overuse headache) are important in primary care because they are common and responsible for almost all headache-related burden.
The burden is immense on workers, women and children in terms of missing work and school days. The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unraveled. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or tension-type headache (TTH) are professionally diagnosed and only 10% of those with medication-overuse headache (MOH).
There are no studies on the burden and disability assessment in patients with primary headache in our country, therefore a need for conducting this study. Goal: The burden and disability assessment in patients with primary headache in Mongolian adults. Methods and Materials: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old randomly were selected from four aimags of Mongolia and three districts of Ulaanbaatar city. They were visited by door to door calling and surveyed using the HARDSHIP and Migraine Disability Assessment (MIDAS) questionnaire. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program, and level of depression in headache present patients was determined by odds ratio (OR). Study methodology introduced at Ethical review Committee of “Ach” Medical University and approved in 2017 (№17/3/2). Results: There were 2043 participants 39.7% and 60.3% of them were men and women respectively. The mean age of them was 38.0±13.4 years. 57.4% (n=1173) of participants had headache, and 27.4%, 30.0%, 11.2% and 7.5% of them had migraine, tension-type headache, chronic headache and medication overuse headache respectively. 42% of participants with headache had the median duration of suffering 7 years (IQR=3-13 years). Out of 1173 participants with headache 20.7% had depression. 23% of participants with migraine had depression whereas 68.2 % and 47% of participants with chronic headache and medicine overuse headache had depression respectively. Participants with migraine were 1.85 (OR: 1.85, CI: 95%, 1.39-2.47) times, with chronic headache 3.40 (OR: 3.40, CI: 95%, 2.04-5.67) times and medicine overuse headache 3.31 (OR: 3.31, CI: 95%, 1,50-7.30) times more likely to suffer from depression compare to participants with no headache.
People with migraine loses their productivity 10.6 days/m, with chronic headache 19.7 days/m, with MOH 20.3 days/ m. According the MIDAS (migraine disability assessment) people with migraine has mild disability, while people with chronic headache and MOH had middle score of disability. Conclusion The prevalence of primary headaches is high among Mongolian adults. These headaches cause disability, impair work, study and daily activities, decrease life quality, and brings unrecognized socioeconomic burden.