Children with impaired hearing have communication and learning difficulty due to delay in the development of receptive and expression communications. Communication difficulties can often lead to social isolation and poor self-estimation. Oral health status in children with impaired hearing tends to be poor due to several reasons as difficulty of adequate training of caregiving parents, parents luck of information and effort. Aim: To study oral health status and oral education level among students of special school №29 for disabled children.A cross-sectional descriptive study. 224 students aged 6-22 years were selected for this study. Participants were subjected to oral examination and were asked to answer to the questionnairePrevalence of caries and DMFT index, dental plague, occlusion and the oral education levels were assessed. The caries prevalence was 95.9%, and the mean DMFT index was 5.5. Dental plaques were identified in 31.7-49.2% of subjects differing among age groups. Among examined children, 32% of subjects had a malocclusion and 18 children underwent cleft lip palate surgical treatment. According to questionnaire 21% of subjects reported that tooth brushing is not significant measure to maintain oral health, which shows that oral education level among subjects was low. Oral health status of children with impaired hearing was in a level comparable to that of healthy children, although the incidence of cleft lip and palate and gingivitis were higher.

BACKGROUND: In Ulaanbaatar, the first case of the pandemic influenza infection has been reported on 12 October 2010.By November 9, a total of 929 cases laboratory-confirmed had been reported to National Center for CommunicableDiseases (NCCD). Of these cases reported, 9 people died.METHODS: The objectives of the study were to describe patients who admitted and hospitalized at NCCD and to determineoverall attack rates among health workers, secondary attack rates among students of colleges and universities. Datawas analyzed using Epi-Info2000.RESULTS: Among 929 of laboratory-confirmed cases, 50.3% (95% CI 43.0-57.5) were males aged 23 (±14.9) in averagewith youngest – 7 months, oldest – 76 years old. Data analysis by districts among the hospitalized patients, showed32.8% (139) of total cases in Bayanzurkh district including the first case of the pandemic influenza infection. The majorityof patients who admitted and hospitalized to NCCD mostly experienced fever (288, 68.1%), dry cough (251, 59.3%),headache (203, 48.0%), sore throat (175, 41.6%). With 1020 physicians and health workers in total, 41.4% (422) ofthem work at NCCD, 35.4% (361) – at MCHRC. 11.1% of health workers out of total become ill with pandemic H1N12009 (overall attack rate 11.1%) with the most common symptom, 380C and higher fever (100.0%, 113), sore throat(83.2%, 94), cough (76.1%, 86) and runny nose (59.3%, 67). The higher attack rates of health workers by occupationwere doctor (18.0%) and auxiliary (13%). The secondary attack rates among university students for influenza-likeillness(ILI) were 12.9%. These secondary attack rates were higher among students of art’s college as compared withother universities (52.4%). For students, the main clinical symptoms were fever + sore throat (75.0%, 18), fever+ cough(70.8%, 17).DISCUSSION: In China, as of 27 September, 2009, from reported total 19981 cases infected with pandemic influenza,61.0% were males, mean age was 17, mainly affected with 83% school students that consistent with our study result.The similar results on clinical symptoms were obtained in Russia. Out of 130 patients, 28.6% had 380Ñ and higherfever, for 54.3% the body temperature reached 38.1-390Ñ where as 17.1% - higher 390Ñ and 96% had cough, 89%had muscle ache, 65% had headache, 14% had diarrhea.

Introduction: Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection. Materials and Methods : The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis. Results: Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July.
Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05). Conclusions Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.

Background: Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults. Materials and Methods: Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B₆, B₉, B₁₂ and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B₁₂ in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B₁₂ was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B₉ was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B₆, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. Conclusion The reference values for vitamins B₆, B₉, B₁₂ and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.

Background: Minerals are important for the proper body functioning. They also play a role in preventing and fighting diseases. Reference values for minerals help physicians evaluate the mineral status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some minerals to be used for evaluation of the nutrition status of Mongolians. Materials and Methods: Two hundred and forty healthy adults (120 males and 120 females) of 17 to 70 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the ethical committee of the Ministry of Health of Mongolia. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of iron (Fe), zinc (Zn) and copper (Cu) were measured by graphite furnace atomic absorption spectrometry. The lower and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean level of blood iron was 30.50 µmol/L (95% CI 29.71-31.29) for men and 30.91 µmol/L (95% CI 30.03-31.79) for women. The calculated reference interval for males was 21.39-37.72 µmol/L and 19.87-39.67 µmol/L for females. The mean concentration of zinc in the blood of males was 11.00 µmol/L (95% CI 10.69-11.31) and that of females was 11.79 µmol/L (95% CI 11.39-12.19). The reference interval for blood zinc was 8.20-14.92 µmol/L in men and 8.52-16.67 µmol/L in women. The mean level of blood copper was 15.28 µmol/L (95% CI 14.64-15.89) for men and 18.08 µmol/L (95% CI 17.30-18.86) for women. The calculated reference interval for copper in males was 9.72-22.34 µmol/L and that in females was 11.18-27.27 µmol/L. Conclusion The reference values for zinc, copper and iron of Mongolian adults do not differ significantly from those observed in other countries. The calculated reference intervals can be used for evaluation of the nutrition status and making clinical decisions.

Background: Reference values are very important for the clinical decisions in laboratory diagnosis and clinical management of patients. Method: A total of 340 adults (apparently healthy individuals) between 18 to 70 years resident in the Ulaanbaatar city were randomly selected and enrolled in this survey. 340 adults made up of 170 males, 170 females were assessed by a clinician to be healthy. About 5 ml of blood was collected with EDTA test tube and analyzed using automated analyser to enumerate the hematological parameters (red blood cell, white blood cell, hemoglobin and haematocrit). Reference values were determined at 2.5^th and 97.5^th percentiles. Results: Reference values estabilished include: red blood cell 4.69-6.04×1012/L, white blood cell 3.98-9.11×109/L, haemoglobin 145-176 g/L, haematocrit 42.6-52.9% for males and red blood cell 4.10-5.20×1012/L, white blood cell 3.50-9.08×109/L, haemoglobin 121.8-148.2 g/L, haematocrit 36-44.7% for females. Conclusion We were determined mean and reference range of haematological parameters (red blood cell, white blood cell, haemoglobin, haemotocrit) which are important for assessing the nutritional status of adults according to the international standard methodology. The international reference range shows that white blood cells counts do not indicate gender and our data (р=0.0964 are statistically insignificant) also offers no significant difference was found between samples for male and female subjects.

Background: We set the average value and reference range of blood plasma proteins (total protein, albumin, transferrin, retinol binding protein, prealbumin) to be used to assess the nutritional status of Mongolian adult. According to step by step research methodology, 170 women, 170 men and a total of 340 people were surveyed using a combination of questionnaires and analytic methods. Methods: The total protein and albumin content of the collected samples was analyzed by colorimetric method using “Humalyzer 2000” semi automatic analyzer and prealbumin, transferring and retinol binding protein was analyzed by ELISA method of “ELX 880”. The lower limit of the reference value of the identified parameters was calculated to be 2.5 per centil and the upper limit was 97.5 per centil. Results: Determining average and reference range of proteins in the plasma of a total 340 participants, the average of total protein was 74.54(CI 95%; 72.67-76.38) g/l for men, and 73.59(CI 95%; 72.39-74.79) g/l for women, while the reference range was 55.26-95.79 g/l for men and 58.38-84.72 g/l for women. According to determined above, there is no statistically significant difference in gender (p>0.40). The average albumin level is 48.20(CI 95%; 47.04-49.36) g/l for men and 46.28(CI 95%; 45.32-47.24) g/l for women, while reference range is 37.14-60.01 g/l for men and 34.97-57.60 g/l for women. It means there is a statistically significant difference for the gender (p=0.012). The average prealbum level is 332.43(CI 95%; 311.28-353.58) mg/l for men, 381.67(CI 95%; 360.98-402.36) mg/l for women, while reference range is 171.3-485.0 mg/l for men and 215.5-535.0 mg/l for women. It means there is a statistically significant difference for the gender (p=0.0012). The average range of transferrin 4.01(CI 95%; 3.76-4.26) g/l for men and 4.43(CI 95%; 4.20-4.66) g/l for women while reference range is 2.20-6.92 g/l for men and 2.58-7.05 g/l for women, is a statistically significant difference for the gender (p=0.017). The average level of retinol binding protein is 1.73(CI 95%; 1.61-1.85) μmol/l for men and 2.01(CI 95%; 1.89-2.13) μmol/l for women, while reference range is 0.73-3.08 μmol/l for men and 0.73-3.08 μmol/l for women, is a statistically significant difference for the gender (p=0.0017). Conclusions For the first time we conducted a study to determine the average amount and reference range of proteins needed to assess the nutritional status of adults (total protein, albumin, prealbumin, transferring, retinol binding protein) according to international standard methods, which is relatively high compared to other researchers. According to the result of the study, it is not possible to directly follow the result of researchers from other countries and the reference range of blood proteins directly to Mongolians. The result of this study has become an important innovation in practice and treatment, as medical professionals have been able to use it in their diagnosis and treatment.

Introduction: Researchers have found that people living in polluted areas have a lower ability to resist skin bacteria and increase the number of skin microflora. Decreased immune function increases the risk of sore throat, influenza, respiratory infections, pneumonia and gastrointestinal diseases. One of the main indicators of the human immune system is the normal microflora. Goal: To study the relationship between normal human microflora and specific immunity. Material and Methods: This study was conducted within the framework of the project “Effects of non-specific immune factors on injectable infectious disease immune system”. The survey sampled 10 households from Dornod aimag, 8th khoroo of Chingeltei district, Ulaanbaatar city, and 3rd khoroo of Baganuur district. A total of 176 people aged 6 months to 50 years were involved. A total of 528 swab samples and 31 blood samples were collected from the throat, tonsils, skin and mucous membranes to study the relationship between normal human microflora and specific immunity.
The research methodology was discussed at the meeting of the Academic Council of the Ministry of Social Welfare and the Medical Ethics Review Committee under the Ministry of Health (January 5, 2018, Resolution 646) and the research was approved. Results: The total number of normal microorganisms in the skin and mucous membranes of the study participants changed, and the number of hemolytic strains and fungi increased. 58%-67% of the participants had normal and long-term immunity against diphtheria and tetanus, while 5% -14% were not. This result was as high as in urban and rural areas. Conclusion This result was as high as in urban and rural areas. As the age group increases, the level of the body’s specific immunity decreases, the structure of the normal microflora changes, and the number of fungi and hemolytic bacteria increases. Furthermore, it is necessary to study specific and nonspecific immunity in detail in relation to environmental pollution indicators.