Objectives: We aim to determine rehabilitation physicians’ attitudes toward and awareness of evidence-based medicine (EBM), level of knowledge and its usage, and barriers to implement it. Design: Cross-sectional survey from a questionnaire distributed in 2010. Setting: The rehabilitation physicians that participated in nation-wide rehabilitation congress in Mongolia. Participants: 58 rehabilitation physicians who responded to a questionnaire (77.3% response rate). Main outcome measures: Rehabilitation physicians’ attitudes toward EBM, level of knowledge and understanding of related technical terms of EBM, clinical use of EBM, level of awareness of and access to EBM literature and databases, and barriers to implementing EBM. Results: Most of the respondents had a positive attitude toward EBM; 91.4% agreed that the use of evidence in practice was necessary; 87.9% agreed that EBM improved patient care; 94.7% were interested in improving the skills necessary to implement EBM. Respondents had a low level knowledge of EBM. Only 39% of the respondents had been trained in EBM, and reported a low level of awareness of some of the technical terms. The practice of evidence-based medicine by a rehabilitation physician was insufficient. Most respondents obtained information of evidence that was necessary for practice from a textbook. Higher than half of the respondents stated they read fewer than 2 articles in a typical month. The primary barrier to implementing EBM was lack of research skills. Conclusion: The respondents had a positive attitude towards EBM and were interested in improving the skills necessary to implement EBM. In the future, the importance of EBM and medical statistics in undergraduate education is suggested. In addition, measures for EBM skill improvement among rehabilitation physicians is of urgent necessity.

INTRODUCTION: Hepatitis B virus (HBV) infection is a highly endemic in Mongolia. Consequently, complications of HBV including livercirrhosis and primary hepatocellular carcinoma, are crucial public health problems in the country. Since 1991, hepatitisB vaccination has been an integrated part of Mongolia’s Expanded Programme of Immunization (EPI). Since the HBVvaccination program has been implemented in Mongolia, there are few studies of HBV prevalence among children, itis essential to assess the effectiveness of HBV vaccination through the prevalence of hepatitis B virus carriage (i.e.,HBsAg) among children in Ulaanbaatar.GoalTo assess prevalence of HBV carriage and vaccination coverage among 4-6 year-old children in UlaanbaatarMATERIAL AND METHODS:∎ A representative, population based cross-sectional study was implemented in Ulaanbaatar.∎ A retrospective descriptive study design was used to estimate the HB vaccination coverage among 4-6 year-oldchildren in Ulaanbaatar.∎ A total of 2200 children, ages 4 to 6 years, were sampled using a stratified conducted, with stratified, multistage,random cluster design from 40 sub districts of 5 districts in Ulaanbaatar.∎ The children, aged 4 to 6 years, (n=1988) were tested for serological marker of HBV HBsAg.∎ All data (dose, species, and date) of the HepB vaccination were collected from the immunization record of thechildren.∎ Closed and open ended questionnaires were asked by parents to assess some social and demographicfactors.RESULT:Of the 2200 children sampled 183 children were not present at their home address and 29 children refused to participatein the study. Thus, 1988 children participated from Ulaanbaatar city (353 of from Khan-Uul district, 440 from Bayanzurkhdistrict, 400 from Bayangol district, 344 from Sukhbaatar district, 451 from Songinokhairhan district) (Response proportion90.3 percent). The mean age of children was 4.97±0.8 years with a range of 4-6 years; 1023(51%) were boys. Rapidtest results are available for all 1988 children; 0.3 percent (n=6) of whom were HBsAg carriers. HBsAg prevalence of4,5 and 6 year-old children were 0.15 percent, 0.43 percent and 0.32 percent, respectively. No association betweengender and HBsAg was identified. The administration of HB vaccine birth dose, HepB2 and HepB3 were 98.2 percent,94 percent, and 91 percent, respectively. Among children with immunization cards, 1089 (81.5 percent) children werecompletely vaccinated, 237 (17.7 percent) incompletely vaccinated and 11(0.8 percent) not vaccinated with hepatitisB vaccine. Prevalence of HBsAg carriage among children with immunization record was 0.18 percent and withoutimmunization records was 0.46 percent.CONCLUSION:Prevalence (0.31 percent) of HBV carriage among the young generation meaningfully declined compared with those ofprevious studies in Ulaanbaatar as a result of Expanded Program of Immunization. There was no significant associationbetween age or sex and HBsAg carriers.

Background: Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity and mortality worldwide. Early-stage detection significantly improves survival rates, with over 90% of patients diagnosed at stages I and II living beyond five years. To improve the early detection of gastric cancer, it is necessary to complement the conventional method of endoscopic examination with biomarker analysis. We aimed to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67 with immunohistochemical analysis. Purpose: A comparative study and evaluation of biomarkers for the early detection of gastric cancer. Materials and Methods: The study was conducted using a retrospective cohort design. Research ethics issues were discussed at the meeting of the Medical Ethics Control Committee of the Ministry of Health on October 13, 2023, and permission to start the research was obtained (Resolution No. 23/051). The information was gathered based on the criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD 10 classification, and participants were selected accordingly. Proteins such as PGC, MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated through immunohistochemical analysis. Results: Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated by immunohistochemical analysis. The mean PGC protein staining values were 6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ± 0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant differences (P<0.001). The mean MMP2 and MMP9 protein staining values were 0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52 and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and 1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically significant (P<0.001). Conclusion PGC protein, a negative tumor marker, decreases during the transition from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki 67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67, and MMP9 can be used for early detection of gastric cancer.