AIMAim of this study was to evaluate Predicted 4 and 10-years risk of major CVD of DMpatients.METHODSCross-sectional study included 80 (40 male and 40 female) DM patients with meanage 66.32 ±7.94 years old. Predicted 4-year risk of major CVD was calculated by usingADVANCE Risk Engine of the George Institute for Global Health, Australia. Ten parameters(age at diagnosed diabetes, duration of diabetes, sex, atrial fibrillation, retinopathy,HbA1C, pulse pressure, treated hypertension, albuminuria and Non HDL-cholesterol)were used for risk calculation. Predicted 10-year risk of major CVD was calculated byusing WHO/ISH risk prediction chartrs Parameters (age, sex, systolic blood pressure, totalcholesterol, smoking) were used for risk calculation.RESULTSOur study relieved that average of diagnosis diabetes was 54.98±9.37 years oldand mean diabetes duration was 11.35±7.46 years. DM patient with atrial fibrillation,retinopathy and treated hypertension were 0(0%), 20(16%) and 77.5(62%). Mean HbA1C,microalbuminuria and Non HDL cholesterol were 7.74±1.5%, 49.99±94.02 mg/l and3.61±1.08 mmol/l. DM patients with <10%, 11-20% and >20% Predicted 4-year riskof major CVD were 64( 80%), 12 (15%) and 4(5.0%). Age (p<0.042), age at diagnoseddiabetes (p=0.013), duration of diabetes (p=0.045), total cholesterol (p<0.027)Microalbuminuria (p<0.001) and retinopathy (p=0.028) were risks for Predicted 4-yearrisk of major CVD.DM patients with <10%, 11-20%, 20-30%, >30% Predicted 10-year risk of major CVDwere 44 (55%), 20 (25%), 6 (7.5.0%) and 10 (12.5%). Age (p=0.008), total cholesterol(p=0.001), systolic blood pressure (p=0.001) and treated hypertension (p=0.023) wererisks for Predicted 10-year risk of major CVD.CONCLUSIONSAmong the diabetic patients 80% have a low, 15% have a moderate and 5.0%have a high Predicted 4-year risk of major CVD. Age (p<0.042), age at diagnoseddiabetes (p=0.013), , duration of diabetes (p=0.045), total cholesterol (p<0.027)Microalbuminuria (p<0.001) and retinopathy (p=0.028) were risks for Predicted 4-yearrisk of major CVD. Among the diabetic patients 55% have a low, 25% have a moderate,7.5% have a high and 12.5% have a very high Predicted 10-year risk of major CVD. Age(p=0.008), total cholesterol (p=0.00, systolic blood pressure (p=0.001) and treatedhypertension (p=0.023) were risks for Predicted 10-year risk of major CVD.

JUSTIFICATION: According to the World Health Organization (WHO), 6.6 million children under the age of five died in 2012 - more than 750 every hour. Most of these children could survive and thrive with access to simple, affordable interventions. The loss of a child is a tragedy - families suffer and human potential is wasted. WHO is improving child health by helping countries deliver integrated, effective care in a continuum, starting with a healthy pregnancy for the mother, through birth and care up to five years of age. Investing in health systems is important to delivering this essential care [1, 2]. GOAL: To study perinatal mortality, this is the most important reason of infant mortality in Mongolia. MATERIALS AND METHODS: A retrospective cohort study was conducted reviewing data from 2007-2011 using the ICD code P00-P96 [4] listing “certain conditions originating in the perinatal period”. Data was analyzed using Epi-Info 2000 and GIS software. RESULTS: Data from 2007-2011 showed that 3091 neonates died from conditions originating in the perinatal period and of these 58.7% (1814) were males. Furthermore, the results of this study showed that the leading causes of death were “respiratory and cardiovascular disorders during the perinatal period” (ICD code P20-P29). More specifically, the causes were: - Birth asphyxia (P21) - Respiratory distress of newborn (P22) - Congenital pneumonia (P23) CONCLUSION: National average deaths per 1,000 live births in Mongolia are 9.5—with the highest rates reported in Dornogovi, Uvurkhangai, Bayankhongor, Gobi Altai, Uvs, Zavkhan and Khovsgol.

Background: The Khongor soum has 253.3 thousand hectare square meter land which is 77 percent of Darkhan aimag from that 31.2 thousand hectare square meter land is used for plantation purpose. 12% of population is kazak. In April 2007, environment and drinking water resource of Khongor soum was polluted by dilution sewage water. Since after this incidence population were complaining about health status. Purpose of this survey was to determine cancer and general mortality of soum population. There 2 objectives: 1. To verify cancer mortality and morbidity in Khongor soum, Darkhan2. To assess excess mortality of cancer in the Khongor soumMethods: Health secondary data of 2006-2009 of Health department of Darkhan-Uul aimag was used for the assessment. The information about cause of death, number of death, population and so on were collected to caluculate crude mortality and cancer-specific mortality.Results: in 2007, the lowest or 4950 population was registered in Khongor soum and the highest number or 5628 of population was registered in 2002. The number of population gradually increased in 2009 by 5603. During 2006-2009 66 people were died in Khongor soum and this means 125.3 populations per 10000. According to the year trend mortality (66) rate was not fluctuated year by year. The leading ten causes of mortality of Khongor soum, at the first CVD (51.1 per 10000) and at the second cancer (37.8 per 10000) and it is similar with Mongolian mortality consistence. According to standardized mortality rate, mortality of Darkhan-Uul aimag was 8 per 10000 and the level of Khongor soum was 0.3 which means less than state average level. During 2006-2009 years, 24 people were died due to cancer and most of them were male (17, 70.8%). Every year of surveyed time, male mortality rate was high. The registered cancer (62.5 per 10000) of soum was similar with state average level and 1.5 times less then Darkhan- Uul aimag (92.5 per 1000) level.Conclusions: The last 5 years mortality rate of Khongor soum (124.9 per 10000) less 2.4 times from Mongolian state average level and 1.9 times less than Darkhan-uul aimag level. There are approved that cancer level of Khongor soum was not increased in last year. However, it is recommended to monitor Khongor soum’s morbidity and mortality to evaluate long-term effect of environmental pollution.

BACKGROUND:Mongolian spots (MS) are congenital birthmarks seen most commonly over the lumbosacralarea. They are bluish-green to black in color and oval to irregular in shape. Dermal pigmentationappears gray, greyish-blue or greyish black because these colors have a shorter wavelength andare reflected to the skin surface. The amount of melanin in the dermal melanocytes, the numberof dermal melanocytes and their depth in the dermis are also important determinants of color. TheMongolian blue spots often fade in a few years and are almost always gone by adolescence.AIM:The aim of this study was to determine the frequency and characteristics of Mongolian spots in 1-10-years-old children.MATERIALS AND METHODS:The study was carried out on 1000 children who were lived in Ulaanbaatar during 2013-2014.Children were carefully examined for the presence of Mongolian spots, including the hairy skin,during the systematic physical examination. If a spot was observed, localization, size, color andshape were recorded. Statistical analysis was done using SPSS-21.RESULT:96.8% (95%CI 95.7-97.8) of the children’s was residents of Ulaanbaatar city, 49.2% [95%CI 46.1-52.5] of boys. The color of the Mongolian spots varied from pale blue to grayish blue. The mostfrequently involved sites were the lumbosacral areas. There was a disappearance in the incidenceof Mongolian spots with advancing age.CONCLUSION:The study shows that prevalence of blue spot among children aged 1-10 years old decreased withage and blue spot tended to disappear after the age of 10.

BackgroundTobacco use is responsible for a considerable number of morbidity and mortality in the World. It isconsidered to be one of the main preventable risk factors of non-communicable diseases. The tobaccosmoke contains more than 4000 substances that are harmful to health, and at least 43 of them arecarcinogenic. Globally, there are 1.3 billion smokers and nearly 5 million persons die every year fromtobacco-related illness. Based on current smoking trends, tobacco will soon become the leading causeof death worldwide. Most people begin using tobacco before the age of 18 years. Recent trends nowindicate earlier age of initiation and increasing prevalence of smoking among children and adolescents.In recent years the number of teenagers and women who smoke has grown significantly, with an averageage of initiation of 16 years.MethodsSurvey uses a global standardized methodology that includes a two-stage sample design with schoolsselected proportional to enrollment size. The classrooms within selected schools are chosen randomlyand all students in selected classes are invited to participate in the survey. The survey uses a standardglobal core questionnaire with a set of optional questions that permits adaptation to meet the needsof the country on tobacco use and key tobacco control indicators. A total of 7,298 eligible students ingrades 7-10 completed the survey, of which 6,178 were aged 13-15 years. The overall response rate ofall students surveyed was 92.3%.ResultsA total of 7298 students were covered in the survey. Amongst surveyed schoolchildren, 77.5% werestudents in grades 8-9 and 53.3% were females. 14.3% [95%CI: 4.7-6.7] of surveyed students (n=5775)currently used any tobacco product. Male students were as twice as more likely than female studentsto smoke daily [20.3%, 95%CI: 17.6-23.4 vs. 8.3%, 95%CI: 6.9-10.1]. 15.6% of students were havingever smoked cigarettes. Among those who have ever smoked, 8.6 percent reported to have first triedcigarette smoking before the age of 10-11 years. Male students were more likely to have earlier triedsmoking than female students (р>0.001). The percentage of students who currently use any tobaccoproduct is increased with the student’s age and it was the highest among students aged 15 years oldat 17.8% [95%CI: 15.2-20.8]. 28.6% of all surveyed students, 28.8% of male students and 31.8% offemale students smoked less than one cigarette per day. 37.4% of students smoked one cigarette perday, 25.5% smoked 2-5 cigarettes per day, 3.5% 6-10 cigarettes per day, 1.0% 11-20 cigarettes perday, and 3.9% smoked 20 or more cigarettes per day. 88.6% of those who tried to stop smoking did itbecause they wanted to be healthy. Of the current smokers, 84.3% think that they can stop smoking ifthey wanted to and most of the current smokers never received help or advice when trying to quit stopsmoking.Conclusion:The survey findings would serve as a baseline information database for undertaking a comparativeanalysis of tobacco smoking across the regions of the country; for evaluating of interventions and activitiesfor prevention and control of smoking related diseases; for establishing of surveillance system anddatabase on tobacco smoking; and for implementing of evidence based public health interventions anddecision making. Students had tried to stop smoking and wanted to quit smoking, however, programs,organizations and professionals who can help them to quit smoking are in shortage.

Introduction“Epidemiological study on prevalence of alcohol consumption, its patterns and alcohol related harms in Mongolia” was carried out in 2006 funded by the WHO as the first consolidated study involving a large scope of sampling. It confirmed that alcohol consumption and related harms became one of the most challenging social and public health problems in Mongolia. Moreover, recent studies provided some data and provided conclusions on high alcohol consumption rate in the population of Mongolia, particularly among adolescents. Alcohol drinking is the primary cause of cancers of the digestive organs, liver, esophagus and stomach in addition to the criminal rate associated with alcohol. Moreover, overconsumption of alcohol affects the human embryos. 58.4 percent of the parents of disabled children are alcohol addicts. (Psychiatric Health Department, UHS).GoalThe purpose of the survey is to study the alcohol consumption by the youth and students.Materials and MethodsA qualitative survey was carried out (focus group interviews, observations) combined with a survey of the target groups (students and youth) selected by random sampling. The target groups consist of students currently studying in universities, higher educational institutions and VTPCs and young unemployed persons aged 16-24. In total, 56 focus group interviews were carried out and 530 people were involved in the survey.ResultsI total, 530 students and young people were involved in the qualitative survey. 72.0 percent of them are the youth aged 16-24 studying in universities, higher educational institutions and VTPCs. This section explored the youth alcohol consumption by asking during the interviews questions such as for what purpose do you drink vodka, how much do you drink one time, what was the reason for your first drinking, what was your impression, where do you drink etc. The focus group interviewees were asked about the type of alcoholic beverages that their generation or peers use. Most of the survey participants started with beer, then try vodka, and then consume both vodka and other alcoholic beverages. A half of the survey participants answered that their peers started drinking alcohol when they were 16-18 and one of every three friends when they were 14- 16. 446 interviewees (84.1%) out of 530 participants have already tried vodka and other alcoholic beverages. 226 respondents (50.7%) who have already tried vodka and other alcoholic beverages consumed alcohol for the first time under peer pressures and influence during some parties or special occasions. One of every four interviewed persons (24.0%, 127) who have tried alcohol before reported that they liked vodka when they tried it first. However, 66.0 percent (350) reported not liking vodka at the first trial and 10.0 percent said they don’t know. Therefore knowledge on alcohol consumption needs to be provided since the school years. Most of the survey participants answered that they use very little alcoholic beverages per week when they were asked about the amount of alcoholic beverages that they drink per week. The majority of the participants who currently use vodka and other alcoholic beverages (56.0%, 177) disclosed that they drink in bars, restaurants and night clubs. (28.0%, 88) of the respondents visit their friends’ home to drink alcohol and (16.0%, 50) just drink on the street. By the social status of the interviewees who currently use vodka and other alcoholic beverages, the majority of the students drink in bars.Conclusions:Participants aged 16-24 who have been involved in the focus group interviews had the following knowledge and understanding about the vodka and other alcoholic beverages:1. Majority of the interviewees demonstrate a belief that alcoholic beverages mean the beverages with lower alcohol content such as beer and wine.2. According to their knowledge, “appropriate consumption” of vodka or other alcoholic beverages means the proper use of alcohols by adults.3. The respondents know that pregnant women, breast feeding mothers, disabled people, juvenile adolescents and drivers are prohibited to drink vodka or other alcoholic beverages.4. Many of the interviewees know that drinking vodka and other alcoholic beverages is legally prohibited to those who are driving.

IntroductionEvery day over the 16000 of people, every year 5 million people pass away due to accident and injury and 500 million people become invalid in the worldwide. It is 9.8% of total death caused by disease, 12.3% of total morbidity. As a result of Mongolian statistical yearbook 1997-2010, “Accident, injury” was at third place of cause of death and at fifth place of morbidity.GoalTo detect risk behaviors which influence on distracting attention of driver and to establish recommendation to change risk behavior during driving.Materials and MethodsThe research will be conducted by quantitative method (questionnaire) and qualitative method (observation and interview). There is 106.848 of cars in Ulaanbaatar and about 10% (n=300) of these is public transportation. 50 of drivers participated at separate interview to detect risk behavior during driving. Research team observed 25 public transportation for 3 hours to reveal driver risk behavior. The data was collected from central 6 districts in Ulaanbaatar.Results:The research involved 290 of drivers from central 6 districts, going to 8 itineraries in Ulaanbaatar. Participants are age of 19-64 and average was 37.4±8.3 age. Age of 30-39 was 44.1 % (128). 92.1% (267) of 290 drivers was drivers of bus, microbus. Most (36.3%, 61) of 168 (57.9%) who not wear seat belt said that not accomplished to use seat belt, 34.3% (56) said that it disturbs to drive a car. 91.7 of drivers said that they are calling during driving. Other 8.3% who are not calling during driving don’t use phone. 99.3% of total drivers listens FM radio, 97.9% talks with someone who sitting near in the car, 95.5% see advertisement near the way which influencing to go down attention of driver. 93.1% of participants answered that don’t drink alcohol during driving. Do you drive a car if there is necessary to drive when using alcohol?-60.0% of them absolutely don’t drive, 34.1 said that a car is driven by another person. 95.5% of participants said that there is no special seat for children in a car. But 46.2% of them has good habit to sit children in back side of a car. But 27.6% said that have habit to sit in front side of a car, 25.9%- anywhere. As a result of research we observed driver common views of public transportation such as sudden forcefully braking, calling, smoking, sitting with anyone in driver cabin, quarrelling with other drives.Conclusion:Drivers demonstrate following behaviors which may leading to traffic accident, involved or not involved in the traffic rule: Most of driver of public transportation bus don’t wear seat belt; Don’t require to wear seat belt from passenger sitting in the back side of car, no seat belt, and cover hasp of seat belt by covering; They have habit to drive a car when using alcohol; Call for long period, quarrel with calling person with loudly, be no normally; Incomplete machine leads to worry for driving period; Don’t convert light at night;

The blue spot distribution in the world and its health effects were published in previous review article. The current article presents the historical overview of blue spot in some Mongolian historical literature sources.For the literature review, we have used ancient Mongolian literature sources such as “Mongoliin Nuuts Tovchoo”, “Altan tovch”, “Erdeniin tovch”, “Shar tuuj”, “Khokh Mongoliig turuur badraakh hutagtai neruit zasag” “Asragch nertiin tuukh”, “Altan deed unenii ayalguu” and other historical, anthropological literature sources and studies.For centuries, Mongolians have symbolized blue as the color of “Eternal Blue Sky”. It is a symbol of long-lasting life, and everything for a Mongolian. In ancient Mongolian historical books, color blue and its symbolism have been recorded.According to some ancient historical literature sources, Mongolians were born with blue spot more than 40000 years ago.As articulated in historical and genetics literature sources, “Mongolian Blue spot” may have been distributed among Native American, Asian and African infants.

Introduction. “Epidemiological study on the non-infectious diseases, accident and injury causes, and relevant risk factors” has been carried out in 2009 by the PHI to determine the alcohol drinking circumstances, frequency and risk factors by gender, age and residency locations. 26.7 percent of this survey participants aged 15-24 used alcohol during the last 30 days, 21.4 percent drank alcohol during last 12 months. GIA, HD (formerly named as the NHDC) carried out the alcohol consumption survey involving 2021 students from the universities, higher educational institutions and general education schools in Ulaanbaatar in 2004. According to this survey results, it is evidenced that 61.0 percent of students use alcohol. The aforementioned surveys and studies were quantitative studies and generally focused on providing cultures and habits of the alcohol consumption. Youth understanding of the alcohols, alcohol’s negative impact and consequences, some social and other factors influencing to the youth consumption of alcohols have not been previously studied.Goal. The purpose of the survey is to study the knowledge, attitude and tendency of the youth towards alcohol and its negative impact, consequences pertaining to the alcohol consumption by the youth and students.Materials and Methods. Qualitative survey has been carried out (focus group interview, observation) and survey target groups’ (students and youth), random selection methods. Target group consists of the students currently studying at the universities, higher educational institutions and VTPCs and unemployed youth aged 16-24. Total of 56 focus group interviews were carried out and totally 530 people were involved in the survey.Results. Totally 530 students and youth were involved in this qualitative survey. 72.0 percent of them are the youth aged 16-24 studying at the universities, higher educational institutions and VTPCs. 67.0 percent (355) of total respondents involved in the survey provided negative responses for the question “in your opinion, what is the vodka”. Vodka is useless chemical substance with negative impacts on human body. Without proper consumption, it can become a poison. It can venom not only body but also the heart and soul. Generally, vodka is one type of instruments to make human beings poor.Focus group interview, 20-24 years old, Female, Orkhon provinceVery small amount of participants involved in the interview responded positively to the question “what is the vodka” - such as the best of food, fluid with 380Ñ alcohol etc. 79.0 percent (419) of the survey respondents answered that alcohol consumption rate in our country is “higher” compared to other countries indicator. A half of total survey participants (272) considered lesser consumption of alcohol for personal use means “appropriate use of alcohol”. Some participants said that it is appropriate use if vodka is served 100-300 gram or 1-3 cups of beers for one serve. Some participants defined the adults as the people aged 18- 50. Most of them said that elders shall become role model if they don’t use vodka or other alcoholicbeverages. Most of the survey participants firstly use beer, secondly - vodka, and thirdly - vodka and other alcoholic beverages. Currently unemployed youth said that their peers and friends generally use vodka. 446 interviewees out of 530 participants, which is 84.1 percent have already tried vodka and other alcoholic beverages. 226 which are 50.7 percent of these youth who have already tried vodka and other alcoholic beverages drank alcohols under peer pressure and influence during some parties or special occasions. Places of drinking vodka and other alcoholic beverages were different for unemployed youth by their gender. For instance, majority of unemployed males visit their friends’ home to drink or drink at the streets, whereas women drink only during special occasions. Some participants said that where to drink vodka or other alcoholic beverages sometimes depend on the seasons – whether it is warm or cold. Conclusions:1. The majority of the students and youth have already tried vodka and other alcoholic beverages. More than half of the survey participants drank vodka and other alcoholic beverages under other’s pressure or influence during special occasions.2. General tendency of the interviewees towards vodka and other alcoholic beverages was negative due to numerous negative phenomena related to alcohols in the society.3. Participants aged 16-24 who have been involved in the FGDs had the following knowledge and understanding about the vodka and other alcoholic beverages: Majority of the interviewees thought that alcoholic beverages mean the beverages with lower alcohol ingredients such as beer and wine.

Background: Due to their limited ability to perceive dangerous situation fully and their inability to react quickly, children are prone to become invalid or even death caused by trauma and/or injury. World Health Organization reports from previous years suggest that illness and death caused by trauma/injury are on steady increase. NTORC records from 2008 indicate that 81.9% of patients aged 0-4 were burned and 15.4% were injured from fall.Goal: The main goal is to study illness and death caused by trauma/injury among children aged 0-5.Materials and Methods: Retrospective analysis was conducted in statistic records of NTORC. Real numbers of illness and death in outpatient, hospitalization were collected and analyzed in SPSS 17.0.Results: Results were introduced in following 2 groups. One. Results of analysis on trauma/injury among children aged 0-5 in outpatient clinic of NTORC: There were 25486 patients aged 0-5 in 2006-2010 totally. Of them, 58% (14790) were male and 42% (10696) were female children. Majority of patients were children aged 1 -2 (45.8%, 11668) and there were no difference in sex in this age group. The most common cause of trauma/illness among children aged 0-5 was burn from heat and chemicals (T20-T25, T26-T28, T29-T32), 2nd most was head injury (S00-S09). Additionally, most of the cases were registered in winter time in 2006, but this difference in season was disappeared in 2007¬2010 records. Two. Results of analysis on hospitalized children aged 0-5: 6393 children received hospitalization between 2006 and 2010. 51.7% (3307) of them were female children. Children aged 0-5 who were hospitalized due to trauma/injury were increased to 25.7% in 2010. Most of the children who received health care because trauma/injury was children aged 0-1 (55.2%, 3526). In source of hospitalization of children aged 0-5, burn from heat and chemicals (T20-T25, T26-T28, T29-T32) was placed first and birth defects, anomaly and chromosomal defects (Q00-Q99) were placed second. From the last 5 years of data, we could see that increase of hospitalization due to burn among male children (47.3%, 1461). Although there are records of burn from heat and chemicals in every month, there are slight increases of cases in May, June and October.Conclusion: Cases of trauma/injury among children aged 0-5 were increased as shown by statistical records of NTORC in 2006-2010. Of all kinds of trauma and injuries, majority of cases were caused by burn from heat and chemicals as indicated from statistical records of outpatient clinic and hospitalization.Recommendation and suggestion:1. Observe trauma/injury among children aged 0-5, particularly burn from heat and chemicals.2. Train statisticians and public health professionals from provinces and soums in methodology of surveillance and research.3. Improve understanding on health effects of burn in children among public, particularly health care workers.4. Organize public health interventions in view of seasonality of some trauma/injury among children aged 0-5.