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;

This survey had conducted for determining respiratory system disease and mortality trend of Ulaanbaatar city population and for developing evidence based recommendations. In accordance with the methodology we had done meta-analysis and statistical analysis on data 2004-2008. For the data analysis we used SPSS and parametric and non-parametric tests were used for determining disease changes and differences of seasonal, age and gender. In recent 5 years, in Ulaanbaatar, respiratory system disease cases are continuously leading 5 leading causes of disease. In 2008, respiratory system disease cases were 865.0 per 10000 populations and it is compare to 2004 increased by 10-30 percent. Children and women are more tend to attend to hospitals due to diseases cases. The survey also revealed that incidence of pneumonia (116.7-145.8 per 10000 populations) was the most visited case from other ICD10 causes of diseases.The mean age of mortality of respiratory system disease was 36.6±31.8 and the oldest age was 101 and the youngest was under 1 year old during 2004-2008 in Ulaanbaatar. During spring season, acute respiratory system disease, chronic bronchitis pneumonia and others respiratory system disease cases were more admitted from the respiratory system disease. Whereas, during autumn season, emphysema, during winter season bronchitis were the leading causes of respiratory system disease admission (x2=33.779, p=0.013).CONCLUSION: The statistics, 2004-2008 in Ulaanbaatar, were showing respiratory system disease trend constantly and continuously increasing. Age, gender and seasonal characteristics were signifi cantly correlated with the respiratory system disease. During these 5 years, 932 deaths were recorded and mean age of dying was 36.6±31.8.

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: A 2023 study by the United Nations University's Institute for Water, Environment and Health concluded that 72 percent of the world's population faces water supply issues, and 8.0 percent are experiencing severe water shortages. Mongolia has received 60 points out of a possible 100 points, and was defined as a country that is unreliable in terms of clean water supply and may face water shortages in the future. A survey of global water security has been conducted. The organization, which has research institutes in 12 countries, compared and ranked 14 indicators of 186 countries, including clean drinking water supply, sanitation, population health, water quality, freshwater resources, water resource sustainability, and governance related to water management. Mongolia scored the highest possible score of 10 out of 14 basic indicators for water availability. However, in terms of water treatment and reuse and water supply sustainability, the indicator of water storage scored the worst, 2 points. Also, Mongolia is weak in terms of governance related to water management, vulnerable to flood risks, and weak against flood disasters in terms of economy and infrastructure. It is concluded that due to the flood disaster, there could be an economic crisis at the national level.
According to WHO statistics in 2019, the mortality rate among the population of Mongolia due to unsafe drinking water and unsanitary facilitation is 3.2 per 100,000 people. It is 15.0 lower than the global average (18.2) and 13.8 percent lower than the average of Asian countries (17.0). According to 2022 Mongolian health statistics, the national average mortality rate due to unsafe drinking water and unsanitary facilities is 16.5 per 100,000 population. Compared to 2014, there was an increase in mortality per 100,000 people at the national and provincial levels. In Ulaanbaatar, which is the center of the total population, the mortality rate increased from 13.3 in 2014 to 16.2 in 2018 and to 23.2 in 2022. In the provinces, as of 2022, it is 10.7, or 12.5 less than Ulaanbaatar. Mongolia has two main types of water supply: centralized and decentralized, 47.9 percent of the total households in Mongolia (n=941,541) live in a fully equipped apartment with centralized and independent utility system. Drinking water service: The WHO-UNICEF Joint Monitoring Program on Water, Sanitation and Hygiene provides international comparisons of progress estimates in the area of WASH and undertakes global monitoring of the associated Sustainable Development Goals. The monitoring program has produced a report based on national and other estimates on the progress made in the water, sanitation and hygiene sector of the countries of the world for 2000-2022. Below are the figures and facts related to Mongolia included in that report. 84.0% of Mongolia's population (n=2,838,017) have access to basic drinking water services as of 2022.
• 39.0% (n=1,334,883) are directly supplied with drinking water from a safe or qualified source of drinking water;
• 44.0% (n=1,503,134) have access to drinking water less than 30 minutes from a basic or qualified source;
• 5.0% of the population (n=173,237) use surface water or water from rivers, lakes and ponds directly for their drinking water needs Sanitary facilities: As of 2022, 66.0% of Mongolia's population have safe sanitation facilities, of which 70.0% of the population in urban areas and 56.0% in rural areas. Although 25% of the rural population used to defecate in the open in 2015, it decreased by 15% in 2022, but 162,972 people still defecate in the open. In 2022, 0.35% meaning 44,066 of the total household population defecate in the open in rural areas. 76.0% of Mongolia's population has access to handwashing soap and water or basic services at home, and 14.0% has limited access to services (limited access to sinks, soap, and water at the household level). 74% of schools in Mongolia are provided with basic drinking water services. 85% of urban schools and 73% in rural areas are provided with drinking water. The study found that 25% of rural educational institutions spend more than 30 minutes getting drinking water from limited or qualified drinking water sources, and 2% have no drinking water. 70% of urban schools and 18% of rural schools have access to basic sanitation facilities. 18% of rural schools have limited services and 24% have no sanitation facilities. 30% of urban schools have limited sanitation facilities.
As of 2010, 43.5% of the households living at home share the toilet with others, 30.7% use it alone, 25.8% do not have their own toilet, 56.5% of the households pour their waste water into the well, and 43.5% of the households that pour it into the open. Solutions for sanitary facilities have been developed and standards for pit toilets and sinks have been developed and approved. The above 4 types of pit toilets are included in the standard. Hygiene 41% of schools in Mongolia have adequate access to basic hand washing facilities. 53.0% of schools in urban areas and 35.0% in rural areas have access to basic hand washing facilities. 41.0% of rural schools have limited access to sinks, soap, or water for students to wash their hands whenever they get dirty, and 24.0% have no hand washing facilities, or schools do not have handwashing sinks or have no water. 13.0% of urban schools do not have hand washing facilities. Before the pandemic (2020) and in 2022, when the epidemic level will decrease in Mongolia, the knowledge, attitudes and practices of the population about the pandemic have been studied. 83.2 percent (95%CI: 81.5-84.9) of participants reported a change in hand washing frequency. Also, 39.1 percent (95%CI: 37.1-41.2) wash their hands in the correct order, 53.2 percent (95%CI: 51.0-55.5) use soap frequently, and 33.5 percent (95%CI: 31.4-35.8) wash their hands 20 times a day. seconds, but about 9.9% (95%CI: 8.5-11.1) answered that there was no change in hand washing practices.

Introduction: During this pandemic, overcrowding in classroom caused by a lack of educational facilities and poor indoor air quality are the main causes of respiratory diseases among children and adolescents. Therefore, it is essential to measure and assess the indoor air quality where children spend extended periods of time such as school. Materials and methods: This study covered four schools with old buildings and four schools with new buildings in Bayanzurkh, Sukhbaatar, Khan-Uul, Chingeltei district of Ulaanbaatar. We collected PM10 and PM2.5, carbon dioxide, air temperature, humidity, and microbiological count from chosen classrooms and compared to the MNS4585:2016 standard. SPSS-24 was used to do statistical analysis on the information gathered during the evaluation. Results and Discussion: The 24-hour average PM2.5 concentration was 64.3 (95% CI: 64.1-64.5) mcg/m3, which was 4.3 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016 standard. The 24-hour average PM10 concentration was 85.3 (95 % CI: 85.1-85.6) mcg/m3, which is 1.9 times higher than WHO guideline value. In older school buildings, the 24-hour average PM2.5 concentration was 5.6 times higher than the WHO guideline value and 1.7 times higher than the MNS4585:2016; the average PM10 concentration was 2.8 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016. The air temperature and carbon dioxide concentration in classroom was met the MNS4585: 2016. The average relative humidity of all schools is 24.2±6.5%, which is 14-16% lower than the MNS4585: 2016. Conclusion The indoor air quality of the school in new and old buildings was similar poor, therefore a variety of steps are needed to improve it.

Rationale: Carbon monoxide (CO) is a colorless, odorless gas produced by carbon-containing substances, most commonly incomplete fuel and biomass combustion. Carbon monoxide deprives the human body of oxygen, leads to severe poisoning and death. In 2017, there were 137 new cases of carbon monoxide poisoning per 1,000,000 people worldwide, and 4.6 deaths per 1,000,000. The global incidence of carbon monoxide poisoning has remained steady over the previous 25 years, while mortality has decreased by 36-40%. Every year in Mongolia, 700-840 persons are hospitalized for carbon monoxide poisoning. Also, there has been a lack of study into the prevalence and causes of carbon monoxide poisoning and death. Goal: Study the dynamics of morbidity and mortality cases caused by carbon monoxide poisoning in Mongolia. Objectives:
To analyze the carbon monoxide poisoning morbidity recorded in Mongolia between 2016-2020.
To analyze the carbon monoxide poisoning mortality reported in Mongolia between 2016-2020. Material and Methods: The survey was conducted utilizing data from outpatient and inpatient poisoning and deaths reported in 2016-2020 with the goal of studying carbon monoxide poisoning and mortality in Mongolia. Workplace exposure poisoning was excluded from quantitative data on carbon monoxide poisoning (fires, suicidal, accidental and domestic explosions, accidents, external effects).The statistics analysis was performed using 23 versions of the SPSS program, to estimate a distribution of new cases and fatalities per 10,000 population depended on age, sex, average number of hospital days, and standard error. ArcGIS version 10.8 was used to map the locations. Results: Acute carbon monoxide poisoning. Carbon monoxide poisoning was 0.01-0.31 cases per 10,000 population during 2016 and 2018. Between 2019 and 2020, it increased to 1.5-1.9 cases per 10,000 population, with up to 37% of those admitted to hospitals. In the last five years, carbon monoxiderelated deaths have been reported in 0.1-0.3 cases per 10,000 population. The amount of hours firing of the households increases every year in September, when the colder season begins. Incidences of death and intentional poisoning were reported in Arkhangai, Uvurkhangai, Khuvsgulaimags, and Ulaanbaatar. The average age of poisoning patients admitted to the hospital was 33 ± 19.5 years old (minimum 2 months, maximum 81). In terms of gender, women registered for 58.4 (734) percent of all cases. The average number of days spent in the hospital was 3.4± 3.7 days.
Carbon monoxide poisoning-related mortality. During the previous five years (2016-2020), 353 people died in Mongolia as a result of carbon monoxide poisoning, although 1.4 percent, or five people, died in hospitals, one case in Bayan-Ulgii, Zavkhan, and Uvs aimags, and two cases in Ulaanbaatar. However, 98.6 percent of them died prematurely at home or in poisoned places due to a lack of access to health care. The average age of carbon monoxide poisoning deaths cases was 35 ± 19.9 years old, and 71.7 (253) percent were male. The Ulaanbaatar, Selenge, Uvs, and Dornod aimags had the lowest death rate of 0.08-0.21 per 10,000 population, while Khuvsgul and Arkhangai aimags had the highest death rate of 0.96-1.57 per 10,000 population. Conclusions Carbon monoxide poisoning among the population rises during the winter season, however, in the previous five years, 96.5 percent of cases have been poisoned accidentally, particularly 82.6 (1035) percent of cases reported in Ulaanbaatar. According to socioeconomic factors, 41.6 (529) of the cases were male, with an average age of 36.5±15.4 years.
During the preceding five years, carbon monoxide-related mortality in Mongolia was between 0.2 per 10,000 people. Without medical attention, 99.2% of cases died at the exposed location or area. The death rate in Khuvsgul aimags was low, whereas it was high in Ulaanbaatar city. The average age of premature deaths was 35±19.9 years, and 71.7 (253) percent were male.

Introduction: Sanitation facility supply and service availability of Mongolia is essential due to the slow process of bacterial decomposition which is getting significant difficulties because of the cold and arid climate. Only 37 percent of Ulaanbaatar’s population is connected to the central sewerage system, and the majority of ger area residents, or 95 percent, use pit latrines in demand of sanitation facility. Numerous studies have shown that the main contaminant of the soil in ger area were pit latrines. It not only pollutes the environment but also affects human health. There is a lack of awareness about the transmission of infectious diseases and options of new sanitation facilities and poor knowledge and bad conditions to introduce new drainage systems. Most pit latrines in ger areas are of poor quality and do not meet relevant standards. Goal: To determine the effect of ”Gipon” ionized disinfectant solution produced by Japanese technology for disinfecting pit latrines Material and Methods: This study was conducted in December 2019 using a random sampling method. Five households in ger areas were selected and pit latrines were disinfected by ”Gipon” ionized disinfectant solution. Results: The survey covered pit latrines of 5 households in the 21st khoroo of Bayanzurkh district. All owners allowed to participate in the survey. The pit latrines are located approximately 9.8 meters away from the households participated in survey. They have been utilized it for 7.6 years and used by an average of 6 people per day. For inner cover, 60.0 percent are lined with wood, and 40.0 percent are cleaned once a month. Before the use of the disinfectant solution, having taken the swab from door handles, floors and walls of the toilet and were detected Enterobacter spp, E.Coli, and Pseudomonas spp in all samples.
However, after one and 24 hours of spreading of the disinfectant solution, the amount of intestinal coliform bacteria and E. coli was reduced dramatically and in some places no bacterial were detected. 72% of the soil near the latrines in the study covered ger areas was contaminated with bacteria. In terms of E.Coli contamination in soil, 60% of them were contaminated in low degree and 32% were medium and 8% were high degree. Anaerobic microorganisms such as Cl.prefrings were accounted for 82% of the total sample, 19% moderate and 81% low contamination. Conclusion Intestinal coliform bacteria (Enterobacter spp, E.Coli, Pseudomonas spp) and pathogenic bacteria (Serratia spp, Staphylacoccus spp) were not detected and the number of fungi was sharply reduced after 1 and 24 hours using Hypon disinfectant. No intestinal pathogens (Salmonella spp, Citrobacter freundii) were found in the soil near the latrine. The amount of coli titers was reached to the acceptable limits. According to this study, the disinfection activity of “Gipon” solution was ranging from 105 to 104.

Introduction: Beginning 15 May 2019, the consumption of raw coal in Ulaanbaatar has been replaced by the consumption of briquette fuel for the improvement of air quality according to Governmental Resolution No.62 adopted in 2018. Since after this resolution has been in placed the number of CO poisoning has been increased as of 18 December 2019, nine persons were died and 1394 people get a health care service due to CO poisoning. However, it has been not been assessed briquette affect to the indoor air quality and its health impact. Thus, it is need urge to define the indoor air quality effect of briquette and its heath impact. Goal: To assess the indoor air quality of the household using the “improved briquette” and identify the causes of the risk. Material and Method: This a cross-sectional survey, conducted from January 31, 2020 to April 31, 2020, data were obtained by quantitative, qualitative (observation, interview) and direct indoor air quality measurement. The survey sampling frame was 40 households in central 6 districts of Ulaanbaatar that used improved fuels (20 households with a history of carbon monoxide poisoning and 20 households that were not affected), and 14 households in the Nalaikh district that used raw coal, in total of 54 households were participated. Indoor air quality was measured by PM2.5, PM10, CO, SO2, NO2, and microclimate per household for 24 hours during a week.
The statistical data analysis was done by the SPSS-23 program and preformed required parametric and non-parametric tests. The normality of the data was checked by the Kolmogorov-Smirnov test. The most of data was not normally distributed. So, thus we used median and used relevant non-parametric tests. The average level of microclimate indicators, and air quality indicators were defined as mean, median and its IQR and standard deviation. The 95% confidence intervals of mean and frequencies were determined and used to differentiate group differences.
The Ethical permission to start the survey was approved by the 2nd meeting of the Ministry of Health on February 4, 2020. The committee was reviewed and approved the research methodology based on whether data collection technique and tools are considered the ethical issues, and whether provided accurate information for make decisions to enroll to the survey for respondents. Results: According to the health statistic, from October 2, 2019 to March 31, 2020, a total of 2,768 people from 837 households were exposed to carbon monoxide poisoning. Of the total reported cases, 10 were drunk, and 2 were due to other disease complications, and a total of 2,756 cases were confirmed diagnosis as carbon monoxide poisoning.
Emissions of CO were recorded every 15 seconds and the results were calculated by conducting continuous measurements per household for 24 hours a week. The level of CO emitted into the indoor environment of households exposed by carbon monoxide had increased during the following time from 7 am to 9 am in the morning, from 13 pm to 15 pm, from 18 pm to 20 pm in the evening, and from 22 pm to 24 pm at night. During this period of time, the indoor air CO level had increased from the WHO mild poisoning recommendation level. Conclusion It has been defined that the carbon monoxide emits to the indoor air households which are using an improved fuel according to measurement the 30 minutes, 31-60 minutes, and 61-120 minutes after burning.

Introduction: In 2020, the prevalence of respiratory system diseases in the population of Gobi-Altai province is 1339.5 cases per 10,000 population, which is 4% (52) more than the average of the provinces and 20% (223.8) more than the national average. In 2021, the number of deaths due to respiratory system diseases was 2.9 per 10,000 population, increasing by 1.1 from 2020 (1.8). Pneumonia-related deaths account for 60.7% of all respiratory system-related deaths. As of 2022, there are 7,281 simple stoves, 248 low-pressure and steam boilers, and 18,207 automobiles in the Gobi-Altai province as sources of air pollution. 63.1% of the total coal is consumed by water heating boilers with a capacity of more than 101 kW, 20.5% by households, and 16.4% by small and medium enterprises. Goal: Determining the relationship between the incidence of pneumonia in the population of Gobi-Altai province and the common air pollutants. Material and Method: According to the rotation research model, the common external air pollutants SO₂, NO₂, PM₁₀, climate parameters, temperature, pressure, humidity, and population pneumonia measurements and registration data of Altai Sum, Gobi-Altai Province in 2020-2021 were analyzed using SPSS-24 software. statistical processing was calculated for non-parametric parameters. Result: The annual average value of sulfur dioxide (SO₂ ) measured in 20 minutes in Gobi-Altai province is 25.2 ± 13.7 μg/m³, the annual average value of nitrogen dioxide (NO₂) measured in 20 minutes is 36.329±29 μg/m³, and the annual average concentration of PM₁₀ particles is 35.2 ± 28,264 μg/m³, which is the standard level of MNS4585:2016. But the 20-minute average concentration of SO₂ (r=0.81, p=0.005), the average concentration of NO₂ (r=0.089, p=0.008), and the average concentration of PM₁₀ (r=0.089, p=0.002) is directly related to the incidence of pneumonia. It is also inversely correlated with air temperature (r=-142, p=0,000). Conclusion Common outdoor air pollutants in Yesunbulag sum, Gobi-Altai Province are related to pneumonia in children aged 0-5 years.

Background: In recent years, the incidence of liver diseases due to complications of non-alcoholic fatty liver disease (NAFLD) has shown a significant upward trend in Southeast Asian countries. NAFLD is a hepatic disorder characterized by lipid accumulation in the microstructure of the liver in individuals who consume little to no alcohol. It is often associated with insulin resistance and is diagnosed when steatosis affects more than 5% of hepatocytes histologically, or when the fat signal intensity on MRI exceeds 5.6%, based on fat-to-water ratio measurements. In Mongolia, histological studies using frozen liver sections with routine and special staining techniques are limited, highlighting the necessity of this study. Aim: To determine and compare the degree of steatosis and fibrosis in frozen liver tissue samples of patients with NAFLD through histological analysis. Materials and Methods: This study was conducted at the the Department of Anatomy, School of Biomedicine and Bio medical Research Institute of MNUMS in collaboration with the Second State Central Hospital. Ethical approval was obtained from the Research Ethics Committee of MNUMS (Protocol No. 2024/3-06). All procedures adhered strictly to laboratory biosafety protocols. Participants were selected among patients undergoing elective laparoscopic cholecystectomy, from whom informed consent was obtained. Based on inclusion criteria, five participants were grouped as follows: healthy control (n=1), NAFLD without fibrosis (n=2), and NAFLD with fibrosis (n=2). Liver biopsies (approx. 1 cm in size) were obtained intraoperatively, immediately deep-frozen in liquid nitrogen, and prepared for histological evaluation. Results: In patients with NAFLD compared to the healthy liver group, disruption of hepatocyte columnar architecture and mild periportal lymphocytic infiltration were observed. Oil Red O staining revealed 34–66% micro- and macrovesicular steatosis, corresponding to grade 2 steatosis. Masson’s trichrome staining showed no fibrotic changes in perivenular or periportal areas (Ishak grade 0/4) at this stage. However, upon progression to grade 3 steatosis, early-stage fibrosis was observed in both perivenular and periportal regions (Ishak grade 1/4). Further progression to stage 4 fibrosis was characterized by the development of connective tissue septa, although no significant changes in droplet size were observed. Conclusions 1. Increasing stages of fibrosis are not directly influenced by the severity of hepatic steatosis in NAFLD. 2. Although the degree of steatosis increases, the absence of corresponding fibrotic changes in early stages indicates a complex progression pattern of NAFLD requiring further investigation.