Introduction In recent years it has been observed epidemiological transition in the world population’s morbidity and mortality causes, indicating a shift from communicable diseases to non-communicable diseases. In 2012, cardiovascular diseases alone accounts for 30 per cent of all deaths in the world. In Mongolia, non-communicable diseases are growing steadily and becoming the leading causes of morbidity and mortality of population. According to the Global School-based Student Health Survey-Mongolia 2010, overall, 19.3 per cent of school children had 4 or more nutritional risk factors of NCD and 8,3 per cent of students were overweight and 0,8 per cent were obese. Above mentioned study shows that, the prevention of NCD should be started from childhood, improving the consumption of fruits and vegetables for school snack and lunch is important in the prevention of NCD among school children. The study is aimed at determination of types, consumption and chemical composition of food products and meals provided in school snack program. Scope and methods of investigation The investigation was performed in Ulaanbaatar and Tuv aimag. Under the our investigation included a totally 14 school canteens of Ulaanbaatar and Tuv aimag. Consumption of Food products was investigated using the Food Consumption Questionnaire method. All managers of school canteens interviewed by well-trained researchers using the time from 20 to 30 min for each of them. Food samples were obtained, keeping in cool boxes, transported to the Public Health Central Laboratory of National Center of Public Health, Mongolia. Chemical composition of food and snack samples were investigated according to the related standard methods for determination of protein, fat, carbohydrates, Vitamin C, Calcium. Results Consumption of vegetables and local fruits for school snack and meal was not enough for prevention of NCD among school children. Use of milk and milk products for school snacks and lunch were obtained only 1-3 times during the 10 days, which is too poor consumption. According to the results of chemical analysis, 83.4 per cent of all food samples had calories less than 340 kcal, which is the required value of calories of school snack per one student. With regard to protein level 50 per cent of samples had 2.57-7.7grams of protein, which is lower than the recommended level of 10-12 gr. Fat level of samples were ranged between 7.2-1.97 grams and 95.5 per cent of samples had lower fat content compared to the recommended value of 9.0 grams. When 68.7 per cent of samples had 4.5-38.03 grams of carbohydrates, which is lower than the recommended amount, some 4.5 per cent of samples had higher carbohydrates compared to the recommendation. Amount of vitamin C in school snack was extremely lower than the recommended amount that vitamin C was found between 0.02-2.31mg, satisfying only 10 per cent of the national recommendation of vitamin C amount for school snack. Amount of Calcium in milk products of school snack and meals was also low than recommended level.

BackgroundSchoolchildren spent most of time in school and the school environment is one of several settings thatcan influence children’s food choices and eating habits. Schools can ensure that the available food andbeverage options are healthy and help young people eat food that meets dietary recommendations forfruits, vegetables, whole grains, and nonfat or low-fat dairy products.GoalTo assess quality of common foods and diet in school environmentsObjectives:1. Define food items and groups in school environment;2. laboratory analysis in sample foods on “School lunch” and around school environmentMaterial and MethodsThirty public and private schools from six districts of city of UB were randomly selected from a list of allschools. Laboratory tests were analyzed total 250 samples from school canteens and within 250 metersdistances around sampled schools.ResultSchoolchildren are exposed to a wide range of unhealthy food and beverages in the school environmentand healthier food and drink’s choices are very limited in these settings. The high availability of differentvarieties of unhealthy food and drinks at affordable prices makes these products the most preferablechoices for children. Overall, 46.5 percent of schoolchildren were served in school canteen and 33.9percent of schoolchildren were served outside of schools including shops and buffet. Main factors of foodchoice were first, like eating (30.2%), food price (27.8%), hungry (16.7%) and food advertisement was6.3% among schoolchildren. Most of common foods (92.5%) were analyzed with high in salt, sugar andlow content of vitamins and minerals around school environment. There was very high sugar content per100 gram products for instance, “Batos” ice-cream 22.75 gr, “Iberry” ice cream 14.05 gr and, “Granat”juice 1364 gr. In addition, fat content is also high in schoolchildren’s common food consumption. Fatcontent tested 31.4gr in chips and 30.6 gr in pie, cake and 26.9 gr in biscuits per 100 gr products.

Introduction. Population life expectancy and health status are directly related to adolescent health,as many chronic disease conditions are affi liated with adolescence. The Mongolia GSHS, 2010 wasstudied dietary behavior and some risk factors belong to non communicable diseases of secondaryschoolchildren among surveyed children. Overall, 5.5% of students have eating habits that are healthybased on the WHO recommendations developed form the Mongolian Ministry of Health. One in sixstudents (15.9%) ate fruits and vegetable fi ve or more times per day. 27.3% of students consumeddairy products valuable for childhood growth two or more times per day. More than one in four students(27.6%) drank carbonated beverages and soft drinks one or more times per day.Findings of this survey show that attention is needed into adolescence and period of young children toprevent and decrease NCD and thus this was a background of our study.Goal. Determine schoolchildren’s food consumption and dietary behavior.Material and Methods. The 2013 Mongolia GSHS employed a two-stage cluster sample designto produce is preventative sample of students in grades 7-12. In total, 60 schools (25 schools fromUlaanbaatar city and 35 rural, respectively) and 203 classes were selected to participate in the MongolianGSHS.School level: The fi rst-stage sampling frame consisted of all schools (urban, rural, public, or private)containing any grades 7-12. Schools were selected systematically with probability proportional to schoolenrollment size.Class level: The second-stage sampling frame consisted of randomly selecting intact classrooms(using a random start) from each school to participate. All relevant classes in each selected school wereincluded in the sampling frame. All students in the sampled classrooms were eligible to participate in theGSHS (2013).“Nationwide health survey based on schools in Mongolia 2013” covered 5393 schoolchildren (age 12-18) from 59 public and private schools. Coverage rate was 89% and total response rate was 88%.Result. According to the WHO recommendations, 18.6 percent (95%CI 17.2-20.1) of students consumedfruits and vegetables fi ve or more times per day. Additionally, consumption of fruits and vegetablesdecreases as age and grade increase.Totally, 31.3 percent (95%CI 29.3-33.3) of students consumed dairy products such as milk, yogurt andcheese two or more times per day in the past month. In addition, 33.0% (95%CI 30.5-35.5) of malestudents eat dairy products compared to 29.5% of female students; that is males consume 3.5% morefruits and vegetables; however there is no statistical difference. On the other hand, 43.4 percent ofchildren aged 12 years or younger consumed dairy products, 32.9 percent of children aged 13 to 15years old and 24.8 percent of children aged 16 years old or older consume dairy products; thus, showinga decreasing trend with age.One of three (33.6%) of students drank carbonated beverages one or more times per day during the pastmonth. Consumption of carbonated beverages differed between males and females (37.6% vs. 29.7%)and increased by age. By age group, high consumption of carbonated and soft drinks was observedamong students aged 16 years old or older (34.4-35.2 percent), while 33.8 percent of children aged13-15 years old, and 29.4 percent of students 12 years old or younger consumed carbonated and softdrinks.Amongst all students, 55.3 percent (95%CI 52.0-69.3) ate breakfast “usually or always”, 26.1 percentate breakfast “sometimes”, and 13.7 percent ate breakfast “rarely or never”. About 1.9% of studentswent hungry to school “usually or always” during the past one month because of insuffi cient food in theirhome.Among participated school children, 26.4 percent (95%CI 21.5-31.9) of students ate fast food three ormore times within the last seven days at restaurants such as Max Burger, Mondonald and their schoolcafeteria. Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.Conclusion1. Fruits and Vegetables: One in fi ve students consumed fruits and vegetables in accordance withthe dietary guidelines for healthy eating and this indicator are increased by 2.7% compared to theprevious study.2. Dairy products: Consumption of dairy products is increased by 4% compared to the previous study;however, it is decreased with age.3. Carbonated Beverages: Consumption of carbonated beverages by students was at similar level inboth, urban and rural areas, and it is increased by 6 points from the previous study level, especiallyhigher consumption was observed among male students.4. Fast Food: Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.

Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.

IntroductionThe imported food products are more than 60 percent of total food consumption of Mongolia. Thelead residue in food products causes chronic and acute poisoning to the human health when exceedsmaximum residues limits, and human exposure and significant public health problems in many partsof the world.GoalTo assess lead residues and health risk of some commonly consumed imported food productsamong Mongolian population.Objectives:1. To determine consumption of some imported food products of Mongolian population;2. To investigate lead residue in some commonly consumed imported food products;3. To assess potential health risk related lead residue.Materials and MethodsThe research used analytic study of cross-sectional study design. Randomly selected 1290 people’simports food consumption was analyzed by questionnaire and body weight measurements. Tooksamples from 145 import products, identified lead residue with Academy of Sciences Soil ResearchLaboratory`s, ASS (USA, 2002) equipment.Results60.7% of imported food samples were lead residues exceeded to Maximum Residues Limits, suchus mean lead residues in meat product were 1.55 mg/kg, in milk product 1.22 mg/kg, in cerealproducts 1.15 mg/kg, in vegetables 1.57 mg/kg, in fruit and fruit juice 1.03 mg/kg, in alcohols drink1.31 mg/kg, and in tea 1.93 mg/kg (p=0.001). Estimated Provisional Tolerable Weekly Intake (PTWI)of lead exposure for survey responses was 0.079mg/kg body weight.Conclusions:1. 60.7% of imported food samples were lead residues exceeded to Maximum Residues Limits,such us mean lead residues in meat product, milk products, fruits and vegetables.2. Imported vegetables (54.0%), cereal 8.4% products (15.5%), fruit and fruit juice (11.8%), andmilk products (8.4%) is main contributing to lead residues in imported food.3. Estimated Provisional Tolerable Weekly Intake (PTWI) of lead exposure for survey responseswas 0.079mg/kg body weight, which is 3.2 times higher than toxicological guidance (PTWI 0.025mg/kg per 1 kg human body weight) and the high health risk level.

IntroductionThe trace elements selenium is a constituent of the antioxidant enzyme glutathione peroxidase. Becauseit boosts the body’s antioxidant capacity, selenium is thought to have some ability to control cell damagethat may lead to cancer. Selenium low status has been linked to increased risk of various diseases, suchas cancer and heart disease.GoalInvestigate serum selenium level of adult mongolians and conduct age and gender coparartive analysisof the serum selenium content.Materials and MethodsCross sectional study was performed among the 2339 apparently healthy Mongolians of both gendersaged ≥18 years. In the study were used questionnaire and biochemical methods. Blood samples werecollected from all subjects and serum selenium concentration was measured by atomic absorptionspectrophotometry method using thermo fisher scientific analyzer.ResultsThe mean and confidence interval of serum selenium level in adult Mongolians was 0.78 μmol/l (95%CI0.77-0.79) and there was no significant difference between genders. Thus the mean was 0.77 μmol/l(95%CI 0.76-0.80) among women and in men it was 0.78 μmol/l (95%CI 0.76-0.80). Data analysisrevealed that older age group individuals were at risk of lowered serum selenium level. In particular,the oldest age group of over 60 years (females: 0.74 μmol/l, 95%CI 0.70-0.77; males: 0.68 μmol/l,95%CI 0.64-0.71). The difference in selenium status between age groups was statistically significant inboth sexes. The overall prevalence of serum selenium concentrations indicative risk of deficiency was59.7%, with no significant differences in the prevalence by genders. Survey findings revealed that riskof selenium deficiency had statistically significant difference between age groups among the surveyedmen.Conclusion: The mean value of serum selenium in adult Mongolians was 0.78 μmol/l and there was nosignificant difference between genders.

Introduction: The introduction of minimally invasive surgery has revolutionized multiple disciplines of surgical practice. Objectives: This meta-analysis of matched case control studies aimed to compare the perioperative outcomes of video-assisted thoracic surgery (VATS) with open thoracotomy for patients with early-stage non-small cell lung cancer (NSCLC). Methods: We searched from PubMed and Embase electronic database and revealed seven relevant studies. Endpoints included perioperative mortality and morbidity, postoperative complications and duration of hospitalization. Two investigators (L.S and D.N) independently reviewed each retrieved article. The values of RR and 95% CI were estimated. We used the fixed and random-effects models to estimate the size of the treatment benefit. Results: Results indicate that perioperative mortality was similar between VATS and open thoracotomy (RR-0.62(95%CI 0.39-0.98). However, patients who underwent VATS were found to have fewer overall complications (RR-0.68(95%CI 0.59-0.78), and patients who underwent VATS had a significantly shorter length of hospitalization compared with those who underwent open thoracotomy (MD= -2.98(95%CI-4.09:-1.87)). Conclusions The present meta-analysis demonstrated superior perioperative outcomes for patients who underwent VATS, including overall complication rates and duration of hospitalization. Therefore, our study suggests that VATS should be performed widely to treat patients with lung cancer in the future.

Nutrition is a key factor in the normal functioning of the immune system, and malnutrition is one of the most common causes of immunodeficiency worldwide today. However, the public health policies on immune system and infection lacks the nutritional strategy to ensure the optimal functioning of the immune system Loss of cellular immunity, phagocyte function, blood protein complex, cytokine synthesis, and A-immunoglobulin secretion are generally associated with protein-energy deficiency.
Some vitamins and minerals, such as A, B6, B12, C, D, E, folic acid, zinc, iron, selenium, magnesium, and copper, plays an important role in the immune system function. Deficiency or low levels of micronutrients can negatively affect the immune system and reduce the ability to fight infections.

Introduction: Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The prevalence estimates of HBV the general Mongolian adult population were found to be 11.1%, respectively.
In April 2017, EASL added a drug newly approved for treatment of CHB, tenofovir alafenamide (TAF) to their list of recommended first-line therapies. The requirement for long-term therapy in chronic HBV highlights the importance of these efficacy and safety trends, however their true clinical relevance is yet to be established and further studies with long-term follow up and real-world clinical data are needed. Goal: Evaluate for result of tenofovir alafenamide in the treatment of chronic hepatitis B infection. Materials and Methods: The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV patients. The trials have similar designs and are randomized, double blind, non-inferiority studies. The primary efficacy endpoint was the proportion of patients with HBV DNA<29 IU/ml at week 24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg seroncoversion to anti-HBs at week 24 and 48. Key secondary safety end- points at week 24 and 48 included the percentage change in T-score, and Z-score bone mineral density (BMD), percentage change in BMD and change from baseline serum creatinine. Results: The primary efficacy endpoint, an HBV DNA level <29 IU/ml at week 24, was achieved by 120 (59.1%) of 203 patients receiving TAF, which was non-inferior to the 63 (55.2%) of 114 patients receiving TDF who had an HBV DNA<29 IU/ml. After 24 weeks of treatment, patients receiving TAF had significantly smaller reductions in bone mineral density (BMD) compared with patients receiving TDF. Conclusion The development of TAF, specifically designed to deliver potent antiviral activity but with an improved safety profile compared with TDF, is therefore timely.

Background: In order to study and evaluate the nutrition situation of the Mongolian people. The 2016-2017 NNS V includes 5 different age groups from Mongolian’s four economic development regions and Ulaanbaatar. The NNS V survey quantifies the prevalence of the nutrition conditions that are of greatest concern to the population, particularly young children and pregnant women. Goal: To establish the prevalence of micronutrients deficiency and estimate micronutrient intake in pregnant women Materials and Methods: Totally 2220 pregnant women included in cross-sectional study from urban and rural area. Survey procedures consisted of interview, anthropometric measurements, clinical examinations, and the collection of biological (blood and urine) samples for pregnant women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration. Result: The prevalence of anemia, as measured by hemoglobin, was 21.4% and the iron deficiency anemia (IDA) was 10.5%, as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was 29.6%.
Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 35.1% and lowest in Eastern region 21.5% (P<0.01). The prevalence of vitamin D in pregnant women was high with 75.4% and 4.4% of all pregnant women had sufficient vitamin D status. An additional 20.2% of pregnant women having insufficient levels. The median concentration of 120.5µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l. Conclusion
1. One in every 5 pregnant women (21.4%) is anemic.
2. Vitamin D intake among pregnant women (7.3%) is very low, with 75.4% having vitamin D deficiency and vitamin D insufficiency –by 20.2%.
3. Median urinary iodine concentration of pregnant women is 120.2mg/l, considerably lower than WHO recommended reference range, indicating pregnant women are at risk of iodine deficiency.
4. Despite visible growth in vitamin and mineral supplements intake by pregnant women, compared to 2010, the infrequency of intake and failure to consume recommended number of supplements as instructed in the relevant guides persist.