Charcot-Marie-Tooth disease (CMT) is a clinically and genetically heterogenous group of disorders. Useful classifi cation is still clinical and electrophysiological classifi cation that divides CMT into CMT type 1 - demyelinating form and CMT type 2 - axonal form. An intermediate type is also increasingly being determined. Inheritance can be autosomal dominant, X-linked and autosomal recessive (AR). In this review, we will focus on the clinical and/or electrophysiological findings and molecular genetics of ARCMT1 (CMT4). Ten genes, GDAP1, MTMR2, MTMR13, SH3TC2, NDRG1, EGR2, PRX, CTDP1, FGD4 and SAC3 have been identifi ed in the CMT4A, CMT4B1, CMT4B2, CMT4C, CMT4D, CMT4E, CMT4F, CCFDN, CMT4H and CMT4J types, respectively. In addition, susceptibility locus on chromosome 10q23 has been found for CMT4G disease. Molecular genetics of demyelinating ARCMT are large disabilities of proteins in Schwann cells and their functions (transcriptional factor, protein transport, protein sorting, intra/extra cellular compartments, signal transduction, cell division, and cell differentiation). It has been rising necessary requirements to defi ne clinical and genetic subtypes of the ARCMT1, prevent from disease, give reproductive and genetic counselling, and develop methods for reducing and clear disease risk factor.

BACKGROUND:The prevalence of overweight or obesity in populations has increased in recent decades in developed countries.The results of Mongolian Steps Survey on the Prevalence of Noncommunicable Disease Risk Factors revealed that21.8% were overweight and 9.8% obese in 2006.Overweight and obesity lead to serious health consequences such as: cardiovascular disease, diabetes mellitus andsome types of cancer.Overweight and obesity is defined as an excess body fat content for statur (Bray GA, Bouchard C, James WPT. 1998).Ideally, the best assessment of overweight and obesity would be a measure of actual body fat (Deborah A, Galuska andLaura Kettel Khan, 2001). Therefore, the aim of this study was to explore the association between overweight or obesityand body fat mass and body- fat percentage levels in Mongolian people.GOAL:The goal of this study was to explore the body fat mass and body fat percentage in Mongolian people by the categoriesof gender, age groups and body mass index categories.MATERIALS AND METHODS:This study was conducted from April 2008 to April 2009 in Ulaanbaatar Songdo Hospital. We were chosen 240 peopleaged 16 to 80 years by the random sampling method.Height was measured using the Ultrasonic Height meter ‘’UHM-101’’ (Jawon Medical Co.Ltd, SK). Body mass index,body fat mass and body fat percentages were measured using a segmental bioelectrical impedance meter (‘’X-SCANPLUS II+Body Composition Analyzer, Jawon Medical Co.Ltd, SK). The percentage of body fat and body-fat mass weredescribed in regard to age, sex, weight and height of an individual.RESULTS: The survey results on BMI categories (WHO 2000), 39.6% had normal weight while 35, 8% were overweight and were15.8% obese I, 7.1% obese II, and 1.7% obese III, respectively. The percentage levels of body fat were 27-31% in malesand 33 - 42% in women aged 39-70 years.Body fat mass and body fat percentage levels were high in population with overweight and obesity.The daily consumption of fat was higher than the Mongolian RDA.CONCLUSION: Body fat percentage levels and body fat mass were increased with age and BMI categories.

Backgroundв Previous the prevalence of myotonic dystrophy was identified very rare, because of the poor diagnostics. In fact, due to getting high quality of diagnostical equipments the disease is determined very common among people in the world. According to some researchers’s statistical data during 1980-1990 years, the prevalence was 1.1 in England, 2.4 in South Ireland, 5.0 in Switzerland per 100.000 population.Goal. The study was aimed to establish the prevalence of myotonic dystrophy in MongoliaMethod. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Results. The prevalence by aimags was ranged from 0.0 to 27.06 per 100.000 population. The average nationwide prevalence is 5.63 per 100.000. Several aimags, especially Gobi-Altai, Orkhon and Khuvsgul are high prevalence with over 3-5 times the average. But in Dornod, Bayan-Ulgii, Dundgobi, Zavkhan, Uvurkhangai, Khentii aimags didn’t have a case of myotonic dystrophy in their population. The rest of aimags have a prevalence from 2.45 (Uvs) to 5.0 (Ulaanbaatar) per 100.000 population.Conclusion1. The relatively high prevalence of myotonic dystrophy was determined among the Mongolian population, especially in Gobi-Altai, Orkhon and Khuvsgul aimags with over 3-5 times the average. 2. The disease is spreading through reproductive way in some isolated populations. There is also a trend of increasing incidence of the disease in urban areas apparently through mechanic way rural to urban migration. 3. The study concludes that there is a need of more intensive response to fight and prevent this disease through upgrading to the modern neurological and genetic diagnostics of the disease, and their regular and sustainable application. Consequently, there is also should be need to create and improve clinical and genetic counseling for patients with this disease.

Background. The prevalence of hereditary spastic paraplegia or Shtrumpel disease is very various in studied countries of the world. It fluctuated between 0.43 (Bulgaria) and 72.4 (South African Republic) per 100’000 population.Method. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Goal. The study aimed to establish the prevalence of hereditary spastic paraplegia (HSP) in Mongolia.Material and Method. This study is part of a general study of the epidemiology of hereditary neurological diseases in population of 14 aimags (provinces) and the capital city Ulaanbaatar (the total population covered by the study was 1’738’000) which is being carried out since 1997. The sizes of population in aimags and the city ranged from 47,800 (Southgobi) to 605,292 (Ulaanbaatar). This study report extrapolates the prevalence nationwide. Diagnosis was established by mainly clinical characteristicsResult. Study revealed 47 patients from 15 families. The prevalence of HSP by aimags was established from 0 to 13.48 per 100’000 population (Uvs aimag). The average nationwide prevalence (1’700’000 above) was established at 2.70/100’000. There are revealed 9 cases (19.1%) in ages of 0 and 14, 6 cases (12.8%) in ages of 14-19, 27 cases (57.5%) in ages of 20- 49 and 5 cases (10.6%) in age above 50.Conclusion1. By prevalence of HSP Mongolia belongs to countries with average prevalence. But the prevalence rates differ by aimags. Patients with HSP in Ulaanbaatar (11 cases) were covered by molecule-genetic analysis by types of the disease, revealing occurrences of II and IV subtypes. 2. Of all patients, 90% are below 50 years of age pointing to the early morbidity with this disease in the context of their early mortality. The situation reveals the need of further moleculegenetic and clinical studies of the types of this disease and of improvement of clinical and genetic counseling of HSP patients.

BACKGROUND: The study of epidemiology of hereditary neurological diseases in Mongolia began a few years ago. Itcovered a few aimags (provinces) (D.Baasanjav, 2000-2005). Previous studies have shown, that hereditary neurologicaldiseases are not rare in Mongolia and structure and prevalence of these diseases vary by aimags. Mo n g o l i ahas 21 aimags (administrative provinces), each with a population from 45000 till 110440. In some “isolated” populationsspecific neurological hereditary diseases can be marked as “indigenous”. So the epidemiological study of hereditaryneurological diseases in Mongolia is one of the urgent medical shortcoming in Mongolia.MATERIAL AND METHOD: We used descriptive epidemiological method for revealing hereditary neurological diseases infamilies in population of 8 provinces (aimags) of Mongolia, Bayan-Ulgii, Bayankhongor, Govi-Altai, Zavkhan, Dundgobi,Khentii, Orkhon, Uvurkhangai, total of 627,000 population. The population of these aimags fluctuated in the range from47959 (Dundgobi) to 110440 (Uvurkhangai). Diseases were diagnosed by neurologists using clinical and genealogicalmethods.RESULTS: The study revealed 77 patients in 40 families in the studied population with variety of neurological hereditarydiseases. The overall prevalence of hereditary neurological diseases for 100,000 population is 12,26. The prevalencevaries by aimags from 2,08 (Dundgobi) to 32,50 (Gobi-Altai) per 100.000 population. The prevalence and their rangeby nosological structure per 100000 population in aimags are: myotonic dystrophy 5.41 widely varying by aimags: from4.66 in Bayankhongor to 27.09 in Gobi-Altai; Charcot-Marie-Tooth syndrome 1.59 and ranging from 2.08 in Dundgobito 4.66 in Bayankhongor; Duchenne muscular dystrophy -0.79 and ranging from 0.90 in Uvurkhangai to 3.19 in Bayan-Ulgii; the limb girdle muscular dystrophy -0.95 and ranging from 1.81 in Uvurkhangai to 4.66 in Bayan-Ulgii; Strumpellfamilial spastic paraplegia -0.95 for total pop and ranging from 2.71 in Uvurkhangai to 5.41 in Bayankhongor; familialparoxysmal myoplegia -0.79 for total pop. and range from 2.22 in Orkhon to 5.41 in Gobi-Altai; spinocerebellar ataxia -0.47 for total pop. (3.91-in Zavkhan); bulbo-spinal amyotrophy -0.32(only in Bayankhongor); spinal amyotrophy of adults-0.16(only in Uvurkhangai); arthrogryposis with myodystrophy -0.63 (only in Khentii); kyphoscoliosis with myodistrophyand nanism -0.16 (1.06 in Bayan-Ulgii)A comparatively high prevalence of all neurological hereditary diseases per 100.000 pop. was established in Gobi-Altai(32.50), Orkhon-26.56, Bayankhongor-15.16, Bayan-Ulgii -11.70 rates; the low prevalence - in Dundgobi-2.08 and-Zavkhan-3.91.The hereditary neuromuscular diseases among all hereditary neurological diseases taken up 71.9% i.e 55 patients from29 families. The myotonic dystrophy is tops the list of neuromuscular diseases (61.8%)CONCLUSION: Hereditary neurological diseases have a relatively high prevalence among the population of Mongolia,specially the neuromuscular diseases; so the control of these diseases in the country is one of the special priorityproblem of the national health care.

BACKGROUND: Multiple sclerosis is spreading in population of Mongolia last 30 years. But there are rare of the date ofprevalence of this disease in Mongolia. So we have studied the prevalence of this disease in population of 8 provinces(aimags) of Mongolia in 2008 year.GOAL: To reveal and establish prevalence and clinical characteristic of multiple sclerosis (MS) in population of 8 aimags(provinces) of Mongolia.METHOD: Revealing of patients with multiple sclerosis in population was made by neurologists, which are possessedof clinical method for revealing or confirm the diagnosis and were taken in register the patients only with confirmeddiagnosis. This study was conducted in following 8 aimags of Mongolia: Bayan-Ulgii, Bayankhongor, Gobi-Altai,Dundgobi, Uvurkhangai, Zavkhan, Khentii, and Orkhon; total population of these aimags is 627762 (m-306482, f-321279). The prevalence of this disease was calculated for 100.000 populations.RESULTS: There have been revealed total 35 patients in 8 aimags. The prevalence for 100.000 population is 5,57 (m-2,61; f-8,40) and has been fluctuated in provinces in range from 1,81 (Uvurkhangai aimag) till 13,28 (Khentii aimag) for100 000 population.The rest 6 provinces (aimags) have prevalence in range from 4,17 (Dundgobi) till 6,38 (Bayan-Ulgii).All patients were distributed by clinical characteristic in next main forms:Cerebro-spinal form in 22 patients (62,8%) among them optico-myelitis in 9 cases (40,9%); Spinal form in 6 patients(17,1%); Cerebral form in 4 cases (11,4%); only optical form in 3 cases (8,6%).Pure spinal, cerebral and optic forms are diagnosed in patients, which have duration of disease no more 6-7 years.By the courses of disease all patients distributed in courses the beginning with acute attack incomplete recovery(remissions) revealed in 18 patients (51,4%), more rapid but steadily progressive course in 5 cases (14,3%), acutesevere attacks course in 5 patients (14,3%).CONCLUSION:1. Multiple sclerosis is spreading in population of Mongolia in last 30 years after 1980.2. The prevalence of this disease in population of 8 provinces (aimags) of Mongolia in 2008 year is 5,57 cases (inmen-2,61; in women-8,40) for 100.000 population. The rates of prevalence of the disease by aimags are oscillated inrates from 1,81(Uvurkhangai) till 13,28 (Khentii) for 100.000 population.3. The women suffered more in 3 time than in man and optic form revealed in 34,2 % cases (in 12 patients). Theage of beginning of the disease was fluctuated in age from 16-19 years old till 60 above years old.4. By level of prevalence of this disease Mongolia now is belonging to countries of the world, which have lowprevalence of this disease (till 10 per 100.000 pop).

BackgroundIn the worldwide, each year registered about 357 million new cases of sexual transmitted diseases.39 % of all infectious diseases were STI diseases in Mongolia in 2013 and which also 56.8 % of totalinfectious diseases Dornod province.ObjectiveTo investigate sexual transmitted diseases among the population of Dornod province and its commonrisk-factors.Materials and MethodsIn the survey were chosen 600 persons which is aged from 15 to 64 by random selection methodand divided into 6 cluster and each cluster had 100 persons. In the survey attended 300 male, 300female.ResultsThe survey respondents were married 59.1%, 50.7% of the employed, and 49.3% of the unemployed.2,1% of the survey population has already been tried drug abuse, but in the group of age 15-24,indicate level of the knowledge about drug abusing is very low which is 29,4%, a little or less knowabout drug abusing 35,6%, not know about drug abusing 35%. In other hand beverage usage levelwas very high which is 67% and 51,3% is using an alcohol in the last year constantly.Examination of specialized doctors 38.3% were suspected of sexual transmitted infections. Theyincluded laboratory testing.The 4.9 percent of total respondents had sexually transmitted diseases. It were syphilis 57.1%,gonorrhea 10.2%, trichomonasis 6.1%.The 83 percent of total respondents had sexual intercourse. The average age of first sexualintercourse was 18 ± 1 (95% CI 16.8 - 19.1), 7.1% had two or more sexual partners. Men had toused alcohol while sexual intercourse was 32.1 percent. Women were 49.2 percent and 38.5 percentof people infected with sexually transmitted diseases not use condoms during sexual intercourse.Conclusion1. One in 20 people surveyed, women aged 15-24 and men aged 35-44 have sexual transmissioninfection.2. Risk factors are had two or more sexual partners, had to used alcohol while sexual intercourseand using condoms during sex with casual partners are not enough.

The number of tick borne diseases is increasing in the world. More than 100000 tick borne encephalitis, tick borne encephalitis cases were registered every year. It occurred in 29 Europien, 4 Asian countries and became public health concern [1]. In our country, virus, tick detection started since 1980 with collaboration Russian scientists. From 1998, collaborative team of Public Health Institute (PHI), National centre for communicable diseases (NCCD), National center for infectious diseases with natural foci (NCIDNF) and Rssian scientists started study of tick prevalence and infection of tick borne encephalitis in Khuvsgul, Khentii, Bulgan, Orkhon, Tuv province. In study of B.Byambaa, M.Dash (1994), 18 species tick were found in Mongolia. Ticks found in 27 soums of 7 provinces. TBE virus infection of tick was 1.2-16.7% in I.persulcatus, 13.7-20% in D.nutalli. Far eastern subtype founded from patient, Siberian subtype founded from tick in Bulgan province of Mongolia. TBEV infection was 1.1-39% among population; highest infection was in Bugan, Khuder soum of Selenge province, Dadаl soum of Khentii provinces. 57.2-59.4% of population was tick bitten and 21-73.7% of them were developed clinical symptoms during surveillance. Symptoms include redness, fever, headache, skin rash, join paint. Most TBE cases were developed fever, headache, vomiting, stiff neck, paralysis. 96% of them typical, 4.4% of them atypical, 60% of them fever, 13.3% meningial, 10% meningoencephalitis among 90 cases in 1998-2004. In review, clinical symptoms of TBE cases that occurred Mongolia similar to cases caused Sibirein subtype.

Background: The data of prevalence of epilepsy in rural provinces among general population in Mongolia is rare. Goal:The study aimed to identify prevalence rate of epilepsy and its characteristics by age and sex among the population in eight provinces (Bayan-Ulgii, Bayankhongor, Gobi-Altai, Zavkhan, Uvurkhangai, Dundgobi, Orkhon and Hentii) of Mongolia.Material and Мethod: This study in the listed aimag populations was carried out by retrospective application and using a questionnaire developed according to a methodology approved by the Academic Council of the Medical Science Institute. For verification of the epilepsy diagnosis, the study based on neurologist examination and EEG. In some suspect cases we used neuroradiological tests including СT and MRI. The diagnosed patients were registered using a special form. The study involved diagnostic examinations of 627762 (306482 males; 321280 females) persons that had at least two unprovoked seizures in their lives. For each case of positive diagnosis we calculated the prevalence rate per 1,000 population in each category of extended age groups (1-12 months, 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-15, 16-17, 18-22, 23-27, 28-32, 33-37, 38-42, 43-47, 48-52, 53-59, and above 60) and by sex.Result: There were 1407 cases (785 males; 622 females) of diagnosed epilepsy among the studied population. The cumulative prevalence rate for all aimags was studied 2,24 (males- 2,56; females-1,93) per 1,000 population. The relatively high prevalence rates per 1,000 population were observed in Gobi-Altai (5,14), Dundgobi (3,31), and Orkhon (2,48) whereas the lowest rate was in Bayankhongor (1, 38). A differential look by sex reveals a high sex gap 6,20 for males and 4,12 for females in Gobi-Altai while Dundgobi (males- 3,84; females- 2,80), Orkhon (males-2,91; females-2,08); Uvurkhangai (males -2,20; females -1,73) show little difference by sex (P>0,05).As for the differences by the detailed age groups, all aimag data shows that prevalence for males ranges between 0,14(1- 12 months) and 5,17 (48-52) and for females between 0,24 (above 60) and 3,82 (38-42). The highest prevalence rate among male population was observed in 48-52 age group, 6,21/1000; followed by age groups 33-37 (2,93/1000); 53-59 (2,84/1000); 38-42 (2,81/1000); and 18-22 (2,38/1000). The highest prevalence rate among female population was observed in 43-47 age group 5,49/1000 followed by 38-42 (5,48/1000); 33-37 (4,0/1000); 53-59 (3,35/1000).Epilepsy prevalence in age groups younger than 11-12 tends to fall for both male and female population. Gender difference in prevalence is that males tend to have higher rates 2,56 than females 1,93 ( P<0,05).Conclusion:1. The general epilepsy prevalence among some rural populations in Mongolia is 2,24 (M -2,56; F-1,93) per 1,000 population.2. The cumulative by all studied aimags data reveal relatively high prevalence rate in age groups of 18-59. This level might be related to men’s vulnerability to traumas and factors of vascular origins while in women it might relate to their physiological transformations of pregnancy delivery and menopause.3. Epilepsy prevalence in age groups under 12 years old tends to fall for both male and female population which might be related to the low level of examination and diagnosis of these diseases among children.4. Compared to some foreign scholars’ data, Mongolia’s epilepsy prevalence rate does not qualify it among the high rate countries.

Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.