Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1959 11- to 17-year-olds from the 2013 Mongolian National Center for Mental HealthMulti-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 66.8% (95% Cl 61.4-73.0%) and a sensitivity of 64.4% (59.9-71.3%). The questionnaires identified over 65% of individuals with conduct, hyperactivity, depressive and some anxiety disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.Community screening programmers based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments

Regardless the possession of any graduation and qualifications anywhere in order to train the doctors and medical professionals with the capabilities to work in any places there are the needs of the knowledgeable mentors to teach their knowledge, abilities and trends to the students in national, regional and international levels. This survey was started to determine the needs of the skills development of the mentors of the Mongolian National University of Medical Sciences under the mission to make it as one of the best 100 medical universities in the Asia-Pacific region and in order to create the favorable environment to accelerate the development of the university and creating a team consists from qualified mentors and researchers by improving the trainings, researches and clinical favorable environment including the quality improvement of the activities.The total of 333 mentors from the 5 structures and 3 branches of the Mongolian National University of Medical Sciences were surveyed to be developed by the University of Michigan including the use of the widely used questionnaires in the universities consisting from 7 groups and 81 questions to determine the needs of the mentors.The working range of the best medical mentors including their needs of the skills was studied. The 55.7% (50.4-61.0%) of the mentors included in the survey were told that the facilitation of the learning needed, 82.4% (78.3-86.5%) as the role models needed, 79.9% (75.6-84.2%) as the provision of the information is needed, 76.3% (71.7-80.9%) as 82.8% (78.8-86.9%) as the planning needed and 81.0% (76.8-85.2%) as the assessment of the training is needed.There is a need to develop the skills related to the 6 frameworks as the learning facilitation for the mentors, role model providers, information providers, resource developers, planners and assessors.

In our country for developing these services closer to the population, providing home care and treatment can be conducted in order to get the patient’s health care refer to the family and sum based health centers should be carried out. At the family and sum hospitals are working graduators of medical university, who assisting health care of Community based rehabilitation. In those cases adoctor have a role to give health care services, and to mediate between disabled people and other health care services as physical therapy, speech therapy, prosthesis and orthotics care, disability surgery and other professional cares. Therefore, there is needs to determine training needs of Community based rehabilitation and to accommodate with study curriculum.To evaluate the curriculum content, retrospective databases and descriptive research method were used and research data was collected by previous data analysis, interview and surveillance.In the result, contents of the “Community based rehabilitation” curriculum in different medicaluniversities are generally the same. But the curriculum was more attached to the disease and its drug medications rather than reflecting to proper guidance and advice for patients and main idea of “Community based rehabilitation”. Availability of specific textbooks and handbooks is limited, hence the trainings are held using international declaration, annual report or guidelines. Also the specialists who teach the subject were inadequate. Relating the due subjects, teaching methods were various, such as problem solving and small group discussion, case study etc., and students were evaluated bytest, case solving, essay writing and for School of Medicine, MNUMS they use OSCE. In conclusion, content of the “Community based rehabilitation” curriculum in undergraduate medical education is not adequate, indefinite, and discordant and there is lack of specialized teachers. Additionally, the curriculum content was not applied to the WHO guidance. Therefore we developed“Community based rehabilitation” curriculum in each medical disciplines, available to be used in undergraduate medical education in further.

BackgroundIn accordance with WHO investigation, most of the mental disorders onset in childhood and 20 percentof children (1 of fi ve) with mental and behavioral disorder currently. In 2005, by assessment of mentalhealth system in Mongolia (WHO-AIMS) it was concluded that special attention needs to be given todevelop professional competence and services in the area of child and adolescents mental health so itis a reason of the this study.AimTo early identify common emotional and behavioral problems among children and identify risk factorsfor itMethodsThe study was randomly selected 3500 child aged between from 4 to 17 years in 5 districts of Ulaanbaatarcity and 46 soums of 11 aimags of Mongolia.A main tool is Strengths and Diffi culties Questionnaire (SDQ) and included the 25-item child andparent versions were used to record each informant’s perception of four problem domains/subscales.SDQ was differently used child ages such as child aged 6-10 years used by parent version child agedbetween11-17 years used by both child and parent versions.ResultsOf 2920 child who participated in the study, 382 (13%) studied in kindergarten, 2423 (82.9%) school. Anaverage age of participants was 10.9±4.ConclusionThe abnormal emotional reaction was dominantly occurred in urban girls aged between from 6 to 10years and the abnormal behavioral reaction was dominantly occurred in urban boys aged between from6 to 15 years. The family relationship was a risk factor for developing emotional and behavioral problemsin child.

IntroductionAs prevalence of morbidity and mortality due to the non-communicable diseases is high, educationand communication are crucial in terms of reduction of the risk factors of these diseases amongstthe population. However, the sources and needs for information regarding NCDs among the generalpopulation, especially among the rural herdsmen, are still unknown.Materials and MethodsThe study used a population based cross sectional design selecting 500 herders in total by themultistage random cluster sampling method from 4 provinces and 12 soums of 4 the geographicalregions of Mongolia. Data collection methods included both quantitative and qualitative methodsfollowed by an analysis of the data using the by SPSS 17.0 software.ResultsA total of 228 herding families participated in the study and 78.5% of them were use television, 37.3%--radio and 10.1% -- newsletters. As for sources of health information, 53.4% of participants receiveinformation on NCDs from the television, 32.2% - from health care facilities, and 18.6% -- from radio.More than 65% of the participants state that the information on NCDs is “insufficient”, whereas 92%have never participated in trainings on NCDs, and 84.4% were have had no access to NCD-relatedbrochures and handouts. These results indicate that the NCD related information available to theherders and rural population is insufficient. In terms of demand for information on non-communicablediseases, 82.2% of the respondents answered that information is necessary, 60.4% of the herdersprefer to have information through television, 42.2%-- through soum doctors and bag feldschers,35.8%-- from health care facilities, and 31.4% -- from the radio.ConclusionInformation on NCDs available to rural herders and households is insufficient, thus more appropriatemethods for delivery NCD information should be used meeting their demands and their preferenceof the sources of health information.

BackgroundChildren’s congenital hip dislocation is ranked first, accounting for 49,4% among other skeletal anomalieswhich cause to physical disability.There is a tendency that the number of newborn with the congenitalhip dislocation is going to be increased in recent years, 5000:1 were in 1976 and 1000:1,3% in 1998.Bilateral dysplasia accounts for 50-62% of the total incidences. In unilateral cases,left hip seems to beinvolved 2 times more than the right,and the sex ratio is 2,5:1. Some cultures who swaddle their infantstightly with their legs straightened have a far greater incidence of developmental dysplasia of the hip. Aresearch indicated that discouraging this traditional swaddling method has reduced the prevalence ofdevelopmental dysplasia of the hip and congenital hip dislocationby 6 times in America. It is noted thatthis methodhas also been implemented in Japan and Turkey.Aim.This research aimed to study about the prevalence of congenital hip dislocation, developmental dysplasiaof the hip and other anomalies among the children who were underwent treatment at Pediatric Traumaand Orthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015 and children served by outpatient visit in the clinics in 2011-2015.The following objectives were defined in the scope of the research. Herein:1. Evaluate and determine the percentage and prevalence of congenital hip dislocation anddevelopmental dysplasia of the hip among the children who undergo treatment in Pediatric Traumaand Orthopedic Departmentof National Trauma Orthopedic Research Center of Mongolia.2. Evaluate and determine the percentage and prevalence of congenital hip dislocation, developmentaldysplasia of the hip and other anomalies among children who are being served by outpatient visit inClinics of National Trauma and Orthopedic Research Center of Mongolia.Materialis and MethodThis research were studied the prevalence of congenital hip dislocation, developmental dysplasia of thehip and other anomalies among the children who were underwent treatment at Pediatric Trauma andOrthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015and children served by outpatient visit in the clinics in 2011-2015.ResultTotal of 40559 inpatients underwent treatment in National Trauma andOrthopedic Research of Mongolia;of which 12217 were inpatient in Pediatric Trauma and Orthopedic Department, aged 0-19;of which1351 has been registered with birth defects of hip; of which 248 has been diagnosed with developmentaldysplasia hip, 869 with congenital hip dislocation. Sex ratio of cases of congenital hip dislocationinmales to female is around 1:4.Total of 633 (13,8%) examinations were performed in the clinics in 2011;704 (15,3%) in 2012;962 (20,9%)in 2013;1013 (22%) in 2014;1287 (28%) in 2015 respectively. It shows an increase in the number ofexaminations year by year.Total of 4142 (90,1%) cases were diagnosed with congenital hip dislocation and developmental dysplasiain both hips; left hip has been dislocated 2 times more than the right, 162 (3,5%) with congenitaldislocation of right hip; 292 (6.4%) with congenital dislocation of left hip.ConclusionTo conclude, the analysis above shows that the prevalence of developmental dysplasia of the hip andcongenital hip dislocation is still high in Mongolia. Therefore, number of diagnosis with congenital hipdislocation has rapidly increased in the recent 2 years.

A school environment may cause positive effect upon health and healthy behavior, but also representmain factor for transfer of non-infectious diseases. Therefore, the issue of maintaining an appropriate environment in operations of training and educational institution would be considered as vital in every country of the world. In our country the solid waste hygienic conditions around children organizations represent one of actual problems. Through the research work was aimed to evaluate the state of solid waste at external environment of general educational institutions by the momentum model of analytical research and involving 103 state proprietary Educational Institutions of 9 districts. At developing estimation list of solid waste at external environment of schools were used current effective standards, resolutions and regulations. 88.3 percent of schools involved into research work had special solid waste-points and 11.7 percent had no special solid waste-points. 38.8 percent of solid waste-points were fenced from all sidesand 44.7 percent fenced from some sides and 16.5 percent had no fence in whole. The research of material from which was made a solid waste-keeping facility showed that 44.2 percent were made from metal, 2.3 percent from wood and 52.3 percent from brick. When we studied whether the solid waste-keeping facility is placed in distance of 25 meters from school according to standard,was determined that 71.8 percent were built according to the standard, 28.2 percent were allocated within 25 meters showing inconformity with the standard. During the research it has been detected that among schools 27.2 percent had too much solid waste-heap, 25.5 percent had placed no special recycle-bins on the school site and 13.6 percent conducted wrong activity by incinerating solid waste on the territory of school.2/3 or total 63 schools among Metropolitan state proprietary educational institutions has non- standard solid waste-keeping facility, 1/3 or 29 schools has located their solid waste-points in non- standard distance, there exists much solid waste-heap because of insufficient recycle-bins, absence of solid waste-points results in collection of solid waste in a special room inside of school and later its transportation with scavenger. Also, 13.6 percent or 14 schools are incinerating their solid waste within school site. This breeches effective hygienic norms and normative.

Background: Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy. Purpose: To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure Methods: Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination. Results: Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole. Conclusion Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Background: In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in Mongolia, studies linking intermediate risk factors to insulin resistance are scarce. Aim: To identify the prevalence of insulin resistance among the population and study its connection with intermediate risk factors of non-communicable diseases. Materials and Methods: This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3- 02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to 2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately 2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes. Results: The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose, 61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased, the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63, p<0.0001). Conclusion 22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes stages.

Background: Obesity and metabolic disorders are significant contributors to hypertension and cardiovascular disease (CVD). While body mass index (BMI) and waist circumference are known to be associated with systolic blood pressure (SBP), the interplay between adiposity, glucose levels, triglycerides, and SBP is not fully understood. This study aims to investigate the relationships between BMI, waist circumference, glucose, triglycerides, and SBP in a large population-based cohort. Methods: A cross-sectional analysis was conducted on [insert total number] participants with complete data on BMI, waist circumference, blood pressure, glucose, and triglycerides. Descriptive statistics, ANOVA, Pearson correlations, mediation analysis, and multiple regression were used to explore the associations between variables. The moderation effect of glucose on the BMI-SBP relationship was examined using an interaction term in the regression model. Results: The mean age of the study population was 44.3 ± 15.2 years. The mean BMI was 26.7 ± 4.9 kg/m², and 22.7% of participants were classified as obese. Central obesity, measured by waist circumference, was prevalent in 55.9% of the population. BMI, waist circumference, glucose, and triglycerides were significantly associated with SBP (p < 0.0001). Mediation analysis showed that waist circumference partially mediated the effect of BMI on SBP. The interaction term for BMI and glucose was significant (β = 0.32, p < 0.05), indicating that glucose levels moderated the relationship between BMI and SBP, with higher glucose levels amplifying the hypertensive effect of BMI. Conclusion This study highlights the complex interplay between BMI, waist circumference, glucose, triglycerides, and SBP. Waist circumference partially mediates the effect of BMI on SBP, and glucose levels moderate this relationship, amplifying the impact of obesity on blood pressure.