Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare. The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.

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.

In pathopsychology, one branch of mental analysis, recently we are using qualitative analyzing methods for mental phenomena. But improvement of professional methods of study, generalization of the new computer based technology, children’s psychology assessment and many other problems are becoming an urgent issue in this field.Our study involved 45 children from orphanage and the High School Personality Questionnaire (HSPQ) computer based questionnaire is used to measure the personality characteristics of orphan children. Spielberg-Hanin test is used to reveal anxiety. Study is analyzed by SPSS program.In total, 45 children (age from 9 to 18), 22 boys and 23 girls participated in our survey. 8.9% of them measured as a high intelligence, 91.1% measured as a lower and an average intelligence. Interestingly, 60% of children were good at controlling their emotions and behavior. Thus 55.6%had symptoms of flexible mind, imagining and probability of affect illness. Having more stress is due to introverted preference and self-blaming, also a feeling of self-blaming is due to not being bold. 51.1% of them assessed that they have dependent, emulative personality and submissive behavior which was very considerably. The anxiety of condition was high in 34.1% of children andlow in 12.2% of them, thus anxiety of individual was high in 36.6% and low in 7.3% of children. Therefore, it’s essential to help orphan children and consider reducing anxiety and improving their self-independence.

Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare.The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.

Objective: To evaluate efficacy of vaccination against tick-born encephalitis by determination of specific antibody titer. Materials and Methods. 224 vaccinated residents (77 females, 147 males) of Selenge aimag with mean age of 33.1(6- 60), 20 worker of Ulaanbaatar with mean age of 36 (23-53) were enrolled to the study. We used Avidity determination of antibodies againt TBE Virus ELISA (Ig G) manufactured by the EUROIMMUN.Result:At 2-6 months after first dose RAI% was in low (29.4-32%), at 1 month after second dose RAI% was in equivocal (53.9%-55.6%), at 6 months after third vaccination RAI% was in high (72.5%-79.8%) avidity antibodies in two groups. That mean RAI% is increasing depend from repetition doses in both schedule. These differences were statistically significant for all post vaccination evaluation days (60,90; p<0.05 ) conventional, and accelerated (60,90,240; p<0.001) schedule. In our study, there are no statistically significant difference (p>0.05) level of RAI% in 6 months after second dose with compared two schedule. But it getting high level of RAI% was developed in short time (before 90 days) with the accelerated schedule than conventional schedule.Antibody titer of 2-200 RU/ ml were observed in all attendants of Selenge aimag. But only 34% of them show a protective titer. In details 62.8% of people vaccinated in 2002-2004, 55.8% of people vaccinated in 2005-2007 and 50.2% of people vaccinated in 2007-2009 year have demonstrated a protective titer. Only 21.7% and 13.4% of people vaccinated by rapid scheme and people received only first dose, respectively, have a protective immunity against TBE.Conclusion:1. The level of RAI% is increasing depends from repetition doses of vaccine TBE with accelerated and conventional schedule.2. The high level of RAI% is getting at 6 months after second dose with accelerated and conventional schedule.3. Complete dose of TBE vaccine develop a better action for establishment of specific protective immunity.

BACKGROUND. In 1929, Mongolian mental health department established and since then it has been showing qualified professional health care towards population. In code of mental health (7.1.2) it is defined as “mental health care can be carried out by person with professional license that indicated in health law” However, recently people tend to seek help from nonprofessional organizations. Because of psychiatric misconception among population, people usually don’t seek help from professional service that it makes diagnostic delay and people suffer longer from their illness. GOAL. To define diagnoses and pathway of people who seek help first-time from mental health care. MATERIAL AND METHOD. This study was relied upon to NCMH out and inpatient unit. Cross-sectional study method with purposive sampling and questionnaire method wasused in this study. RESULT. In total of 145 patients, 76 males and 69 females, who are aged between 18 to 56 years participated in our study. According to ICD 10, majority of participants (40.7%, n=59) had schizophrenia and schizophrenia spectrum disorders, 21.4%had stress induced disorder, 12.4 % had organic disorder, 11% had affective disorder, and 14.5 % had substance use disorder.According to their help seeking pathway, every patient sought help from professional organization or several nonprofessional organizations and individual person. As we demonstrated the initial help seeking pathway of participants 40% sought help from religious service, 26.2% sought help from psychiatrist, 17.2% sought help from general and 16.6% sought help from other professional doctors. Therefore we demonstrated the amount of participants who sought help from nonprofessional organization and individual person that 60.6% sought help from shaman, 62% sought help from lama. Primary or secondary educated people are tend to seek help from religious service which was statistically significant (p≤0.006).in total of 107 participants sought help from nonprofessional organization and each patient spent about 5,629,122.30±928799 tugrug, but average of total medical fee for per patients in NCMH was 83916±7793 tugrug which costs 7 times lower than nonprofessional organization but improves patients` mental state more, significantly (p≤0.001) Primary or secondary educated patients likely to have diagnostic delay 1 time more than high educated patients, people with nonprofessional initial help seeking likely to have diagnostic delay 2 times more than psychiatric initial help seeking patients and people who imply that religion causes mental illness have diagnostic delay with 2 times more, significantly. (p≤0.001). CONCLUSION. According to study result stress induced disorder and schizophrenia were the majority of total participants. People tend to seek professional help far lately from symptom onset. Psychiatric misconception and inadequate health education among the population are the main reason of diagnostic delay.

ХУРААНГУЙ. Дутуу төрөлт нь анагаах ухаан төдийгүй нийгэм эдийн засгийн тулгамдсан асуудал юм. Дутуу болон жин багатай төрөх нь нярайн эндэгдэлийн тэргүүлэх шалтгааны нэг болж байна. Шүдний тулгуур эдийн үрэвсэлт өвчний үед зарим нянгийн бүрэлдэхүүн хэсгүүд нь жирэмсэлтийн явц ба ургийн хөгжилд нөлөөлж болдог гэдгийг харуулсан судалгааны үр дүнгүүд байдаг. Иймээс жирэмсэн эмэгтэйчүүдийн тулгуур эдийн өвчин нь нярайн дутуу болон жин багатай төрөх эрсдэлт хүчин зүйл болж байгаа эсэхийг судлахад энэхүү судалгааны зорилго оршино. Уг судалгааг эмнэлэгт суурилсан тохиолдол хяналтын загвараар Нийслэлийн Өргөө Амаржих Газар болон Эх Хүүхдийн Эрүүл Мэндийн Үндэсний Төв (ЭХЭМҮТ)-ийн нийт 90 оролцогчийг хамруулан хийж гүйцэтгэлээ. Тохиолдлын бүлэг 30 (37 долоо хоногоос бага тээлттэй, 2500 гр-aaс бага жинтэй нярай) оролцогч, хяналтын бүлэгт 60 (хэвийн тээлттэй) оролцогч хамрагдсан. Судалгаанд оролцогчдийн шүд цоорох өвчний (ШЦӨ) тархалт хяналтын бүлэгт 99%, эрчим 8.32 ЦЛА/ш, тохиолдолын бүлэгт ШЦӨ тархалт 100%, эрчим 11.33 ЦЛА/ш байв. Амны хөндийн эрүүл ахуйн (АХЭА) үзүүлэлтийг үнэлэхэд хяналтын бүлэгт 2.4 буюу ‘’дунд’’, тохиолдолын бүлэгт 3.2 буюу ‘’муу’’ үнэлгээтэй байлаа. Тулгуур эдийн өвчин, шүдний чулуу (***p<0.008), шүд буйлны эмгэг хөндийн гүн 4-6 мм байх нь (***p<0.006) жин багатай дутуу нярай (ЖБДН) төрөх эрсдэлт хүчин зүйл болж байгаа нь статистик ач холбогдол бүхий үр дүнг үзүүллээ. Буйлны үрэвсэл нь ЖБДН төрөх эрсдэлийг 5.5 дахин нэмэгдүүлж байна. Community Periodontal Index of Treatment Needs (CPITN) үзүүлэлт нь АХЭА үзүүлэлтээс хамааралтай болох нь статистикийн хувьд ач холбогдолтой байлаа (***р<0.000). Тулгуур эдийн өвчин шүдний чулуу, шүд буйлны эмгэг хөндийтэй байх нь ЖБДН төрөх эрсдэлт хүчин зүйл болж байгаа нь судалгааны үр дүнгээс ажиглагдлаа.

Preterm birth is not only health problem but also one of major socioeconomic issues. Preterm Low Birth Weight (PLBW) is leading causative factor of neonatal mortality. Some researches results showed that during periodontal inflammatory disorder some bacterial components could affect pregnancy and fetal development. Therefore aim of our study is to assess and confirm periodontal disease of pregnant females whether or not risk factor of PLBW. We performed our study on the First Maternity Hospital and National Centre for Maternal and Child Health of Mongolia by clinical based case control method on 90 participants. Case group has 30 females (<37 weeks of gestation, and Neonates Birth Weight <2500), control group has 60 females (Normal birth) (ratio was 1:2). Dental caries prevalence on control group was 99%, the mean of DFM/t was 8.32 “average”, prevalence of case group was 100%, and mean of DFM/t was 11.33, which was also “average”. Oral hygiene examination assessment was poor. Study results showed that patients with periodontal disease such as dental calculus (***p<0.008) and periodontal pocket with depth of 4-6mm (***p<0.006) were risk factors for PLBW. Gingivitis is increased to have PLBW baby by 5.5 times. CPITN index was highly associated with dental hygiene index and it was statistically significant. (***p<0.000). Within the limits of this study poor periodontal health status of mothers may be a potential risk factor for a preterm low birth weight.

INTRODUCTION:In connection with request and financial assistance of Swiss Development Agency ‘’Mercury exposureand health impact assessment study among small scale miners in mercury free technology, wasconducted by researchers of Toxicology division of NCPH.GOAL:To determine mercury exposure level in biological samples of local small scale miners from mercury freetechnology introduced area. To reveal chronic mercury intoxicated patients,MATERIALS AND METHODS:Totally 147 artisanal miners from 33 cooperatives for small scale mining from Bayan-Îvoo soum ofBayankhongor, Bornuur sum of Tuv, Bayangol, Mandal and Tunkhel sum of Selenge province areparticipated in this study and the study was performed by cross sectional study methods during April toDecember, 2014.Over all 147 participants were in the first part of study, 60.5% out of 147 (89 participants) were in secondparts, and another 35.4% (52 people) were participated to the third parts of study. The participants wereundergone in to toxicological, dermatological and neurological examinations and the WHO guidance formercury exposure determination was followed in this study.RESULTS:On the results of all testing we revealed that there were 2 cases of chronic mercury intoxicated patientsfrom each Bayangol Bornuur soum, 2 from Mandal soum, and 3 from Bayanovoo soum.Overall 7 patientswere diagnosed as chronic mercury intoxicated and it comprised 4.7%of (n=147) all involved participants.We have observed that average height of total medical examination number was (2.9) in Bornuur soum.It indicated that there will have higher number of patients would exist in Bornuur soum than others.Ourstudy result has shown that neurological symptoms like tremor and imbalance were more diagnosedamong participants from Mandal and Bayngol soums. It implies that the health of the small scale minersfrom this soum more affected and needed to be investigating further.CONCLUSIONS:Mercury is still being used among artisanal gold miners even thoughit is still illegal. Further medicalevaluation and assistance needed to be taken for newly diagnosed 7 patients.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.