Breast cancer management is an inevitable intertwining between multiple disciplines. Pathologists remain largely responsible for making the diagnosis that determines a patient’s management and prognosis. Simple morphology based classifications and tumour grading are now being complemented by exploration of disrupted cell pathways with the use of immunohistochemistry and molecular techniques that enable us to better predict cancer progression and response to treatment. This talk will explore how our understanding of breast cancer has evolved and how this has been central to the evolution and advances in breast cancer management.

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Background. Echinococcosis are parasitic zoonoses, remains a public health problem of worldwide, including Mongolia . Differential diagnosis between E.granulosus and E.multilocularis has significant implications for epidemiologic studies, treatment of these diseases, since both species occur in Mongolia. Serodiagnostic tests based on detection of antibodies against genus and species-specific antigens have played an important role in differential diagnosis, confirming clinical diagnosis and in epidemiologic studies.Materials and Methods. A total of 107 volunteer participants’ serum samples and additional 11 serum samples from the persons with hepatic cysts were tested for specific IgG against recombinant AgB and recombinant Em18 antigens in an ELISA .Results.rAgB-specific antibody was detected in 2 (3.33) of 60 individuals from Bayankhongor province and no one had positive response to this antigen in 46 individuals from Ulaanbaatar city while rEm18-specific antibody was present in 7 (11.66) and 3 (6.38) respectively. The one individual with typical lesions of active echinococcosis in a liver revealed by abdominal ultrasonography showed significantly higher IgG antibody response to rAgB. We suggest that people need to be provided information not only about cystic echinococcosis but also alveolar echinococcosisand improvement of sanitation and hygiene and to be careful with corsac and red foxes and their feces to prevent those infections.

Use of nanoparticles (NPs) in several commercial products has led to emergence of novel contaminants of air, soil and water bodies. The NPs may exhibit greater ecotoxicity due to nano-scale dependent properties over their bulk counterparts. The present investigation explores the effect of in vitro supplementation of TiO2, silica and silver NPs on radial growth and ultrastructural changes in the hyphae and spores of two mushroom genera, Ganoderma lucidum and Volvariella volvaceae. A concentration dependent decrease in radial growth on NP amended potato dextrose agar medium was recorded. However, in comparison to control, there was decrease in radial diameter on supplementation with TiO2 NPs while an increase was recorded for silica and silver NPs amendments as compared to their bulk salts at same concentrations after 48 h of incubation. Optical microscopy studies showed decrease in the number of spores while increase in spore diameter and thinning of hyphal diameter on NPs supplementation. Scanning electron microscopy analysis of fungal growth showed presence of deflated and oblong spores in two fruiting strains of Ganoderma while Volvariella exhibited decreased sporulation. Further, hyphal thinning and branching was recorded in response to NP amendments in both the test mushrooms. Enhancement of protein content was observed on NP compared to bulk supplementation for all cultures, concentrations and hours of incubation except for TiO2 NPs. Likewise, bulk and NP supplementations (at 100 mg L−1) resulted in enhanced laccase activity with occurrence of laccase specific protein bands on SDS-PAGE analysis.

Although the students are subjected to some formative exams throughout the problem based learning units, feedback is not given appropriately and timely. Students want to know and use the reasoning behind judgments and always complain that assessment criteria need to be explained. The aim of this project is to implement a two-way feedback delivery (TWFD), in which both faculty and students have an opportunity to discuss their reflections on learning and examination processes. An Anatomy formative assessment is introduced to 100 students followed by implementation of TWFD. Faculty members provided the students with a structured and timely feedback on their performance. Also, the students reflected on the whole learning process, including real examination experience. The reaction was measured using quantitative and qualitative instruments through a questionnaire, focus group discussion, and semi-structured interviews. Ninety students (90%) participated in the questionnaire with high satisfaction toward implementation of TWFD. Ninety-four percent (n=85) admitted that the time of the session was appropriate. Ninety percent (n=81) of the students demonstrated that the TWFD helped them to identify their strengths and weaknesses. Eighty-five percent (n=77) of the students admitted that TWFD promotes active reflection on the effectiveness of teaching. Most of the students and teachers' comments in the focus group discussions and the interviews supported these results. TWFD seems to be a good approach to implement an effective and timely feedback process between the faculty and the students. Students and the faculty recommended the implementation of this session in different courses and units.
Education, Medical ; Focus Groups ; Humans ; Judgment ; Learning* ; Methods* ; Problem-Based Learning

Background. Bacterial meningitis is a severe, potentially life-threatening infection that is associated with high rates of morbidity and significant disability in survivors. Overall mortality rates related to bacterial meningitis of around 20% to 25% have been reported by major centers. Our study is to determine the incidence rate and etiology of childhood bacterial meningitis in Ulaanbaatar, Mongolia.Methods. From 2002-2010, a total of CSF 433 and blood 544 samples were obtained from children age 0-5 years old. The following diagnostic criteria for bacterial meningitis in children aged 0-5 years were used: questionnaires, clinical signs and positive CSF culture and/or CSF antigen test results positive N. meningitis serogroups B, A, C, Y, and W-135, Hib or S.pneumonia; and/or positive CSF PCR results; and/or positive blood culture results with CSF pleocytosis (WBC count, >10 cells/uL). Pathogens were identified and serotype or serogroup with standard methods in the reference microbiology laboratory. Detection of bacterial pathogens with a multiplex and real-time PCR assay.Results. From totally 544 suspected cases had been detected bacterial meningitis in 260 (47, 8%) cases and sepsis in 111 [20,4%] cases respectively. The disease in the 83 [27.1 %] etiologically diagnosed patients was due to H.influenza, S. pneumonia was in 71 [36, 4%] cases and N.meningitis in 111 [24, 7%] respectively. Among the positive samples 80.6% (129/160) the specific serogroup and/or serotypes for N.meningitis serogroups A was available in 22(35, 4%) cases, for the Hib 52(96, 3%) and 6(40%) for the S.pneumoniae 7 serotype. The real time PCR assay was more sensitive for detection of meningitis pathogens than conventional methods (culture and latex agglutination), 19% in comparison with latex agglutination (p<0.0026) and by 39% in comparison with culture (p<0.001). Bacterial meningitis was identified 70.0 in 2004 among population, but it reduced until 5.0 in 2009. The incidence of Hib meningitis was 2002-2005y, N.meningitis and S.pneumoniae meningitis were 2006-2008y, S.pneumonia meningitis was more higher 2009-201 Oy comparing with other pathogens.Conclusion. N.meningitidls, S.pneumoniae H.influenzae type b are the leading causative agents of childhood bacterial meningitis in Ulaanbaatar, and the incidence rate is higher than what were reported in other Asian countries.

: Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Globally, the prevalence of obesity and overweight tripled in the child and youth populations from the mid-1970s (about 4%) to 2016 (greater than 18%). In 2016, more than 330 million children and adolescents were affected by overweight or obesity globally. It is estimated that by 2030 nearly 30% of all children will be affected by overweight or obesity. For this reason, childhood obesity is a major public health problem worldwide.
This study summarizes and reviewed research findings related to childhood obesity and health risks. Overweight and obesity are defined as an abnormal or excessive accumulation of fat that can harm health. Obesity has a multifactorial origin that involves both genetic and environmental factors. Several studies showed that excess body fat increased the risk of multiple comorbidities, such as high blood pressure, coronary heart disease, type 2 diabetes, insulin resistance, and cancer. According to the results of the research, the mother's nutritional status and obesogenic environments have a great influence on childhood obesity. A summary of the results of many studies concluded that childhood obesity is more likely to develop non-communicable diseases in adulthood. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2–4 years has increased moderately. Overweight or obesity during childhood has important short-term and long-term consequences. Conclusion In recent decades, the prevalence of obesity in children has increased dramatically. For the successful implementation of activities to prevent overweight and obesity in children, it is necessary to create a supportive environment and to promote health.

Purpose: To evaluate the feasibility, efficacy, and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods: Eleven patients with CP/CPPS were enrolled in this prospective clinical study. rTMS was performed for 5 consecutive days in 20-minute sessions. Patients were evaluated at baseline, after treatment, and at 1, 4, 8, and 12 weeks after the last session with questionnaires concerning pain (numerical rating scale [NRS], the National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI], and the Short Form-36 [SF-36]), urinary symptoms (NIH-CPSI, Danish Prostatic Symptom Score [DAN-PSS-1]), quality of life (NIH-CPSI, SF-36), and psychometrics (Beck Depression Index [BDI]). Telephone-based interviews were used to evaluate side effects, subjective response, and changes in drug consumption. Results: All patients completed the planned treatment and follow-up according to protocol. No patients experienced serious side effects or significant pain increase during or after treatment. Mild transient tension headache responsive to oral pain medication was reported by 2 patients. Decreased pain was observed on the NRS after treatment and at 1 and 8 weeks (P=0.019, P=0.006, P=0.042, respectively) and on the NIH-CPSI pain domain at 1 week (P=0.04). Improvement in lower urinary tract symptoms was observed after treatment in the NIH-CPSI urinary domain (P=0.02) but not with the DANPSS-1. No significant changes in the BDI were observed. Nine patients reported a positive overall subjective response (82%) and 6 patients (55%) were able to reduce pain medication. Higher age was associated with lower NRS scores after treatment (R=0.605, P=0.048) and at 8 weeks (R=0.659, P=0.028). Conclusions rTMS for patients with CP/CPPS seemed to be well tolerated, at least moderately effective in pain reduction, and might be of interest in patients with chronic pelvic pain resistant to conventional treatment. These findings remain to be confirmed by a randomized trial.