Vitamin D deficiency is a major health problem worldwide, especially in the elderly, so that an accurate assessment of its prevalence is essential for planning reliable healthcare policy throughout the lifespan. Purpose: The aim of the oncentrationofpresent study wasto assess the25-hydroxyvitamin D 25OHD) across different as well as the mild andmoderate deficiencies ages and genders. Methods: We searched the database of the local Laboratory Information System to retrieve results of 25OHD tests performed on the whole cohort of presumably Mongolian participants aged >22 yrs, who were referred to our laboratory in Gurvan Gal Hospital’s clinical laboratory, a 1-year period (January 2011 - January 2012). Results: Results for 25OHD testing were retrieved for 120 participants. No significant differences between females and males were observed for 25OHD values(20 [4-17.89]ng/ml versus 53 [4-20.06]ng/ml; p=0.3). A non significant variation of 25OHD values was also found by ANOVA analysis throughout 3 age cohorts (22-40, 41-60, >60 yrs), in both genders. In each age group, the values of 25OHD did not significantly differ between genders. Conclusions: We observed a high prevalence of vitamin D deficiency in a Mongolians. Lifestyle factors, including smoking, and physical activity, were significant predictors of serum 25-hydroxyvitamin D concentration.

IntroductionMongolian rural population lack of access to adequate health services due to the fact that they live remotefrom urban hospitals. With the rapid spread of telemedicine in most countries, has been promoted as apromising tool to address deficiencies in delivering health care in developing countries.In late 2008 the Swiss Surgical Team (SST) started the telemedicine project MonTelNet in Mongolia incollaboration and with financial support of the Swiss Agency for Development and Cooperation (SDC).GoalThis study aims at evaluating the diagnostic accuracy of such a service by reviewing 212 telepathologydiagnoses delivered to the local experts in Ulaanbaatar between January 2009 and June 2013.Materials and MethodsUnder the MonTelNet project all province (Aimag) hospitals were equipped with hardware necessaryfor practicing telemedicine, in particular with computers with digitalized microscopes and cameras. Thesoftware CampusMedicus® (CM) was developed together with Klughammer GmbH. Software and alldata and comments exchanged over the MonTelNet are stored on a central server. Each of the originaldiagnoses issued through the CM telepathology (TP) server was compared to an independent reviewdiagnosis based on the original glass slides.RESULT For 188 specimens (89.9%) the TP diagnosis were completely identical with the review diagnosison the original glass slide. 12 specimens (5.7%) showed minor discrepancies (clinically identical) and 5specimens (2.4%) showed moderate discrepancies which were not clinically relevant. four cases (1.9%)exhibited a marked discrepancy (clinically relevant) between the TP diagnosis and the review diagnosis.Three specimens were classified as “other”.DISCUSSION The results of the study show a very high accuracy of the TP diagnosis provided. The TPdiagnoses differed markedly from the review diagnoses based on the original glass slide in only 1.9%of the 212 cases. 89.9% of all cases showed complete concordance between TP and review. Thesefigures are comparable to figures from other evaluations of static image telepathology.Conclusion:1. The results of the study show a very high accuracy (94.7%) of the TP diagnosis provided. TheTP diagnoses 89.9% of all cases showed complete concordance between TP and conventionalreview.2. Problem with image selection show a different picture and occur more often in cases with markeddiscrepancies between TP and review - χ2-test shows significant correlation (p<0.001).

Based on registered cases Н1N1 virus Influenza in Mexico, 26 April, 2009, there were done risk assessment of current and future situations in area along railway across Mongolia. In the frame of this work were done organizational work preparation, urgent activities to prevent the infection The result of this risk assessment were passed this situation with less risk and related activities were done by steps.Work of Making Sure of ReadinessBy the order number 22b of Vice Chairperson of the Security Departure of Railway, on 28th of April, based on act number 02 of the National Emergency Department, group of agents had been assigned on UBRW, on 6th of May ‘’Plan to Prevent and Making Sure Quick Response is Ready from H1N1 Virus Influenza Infection’’ had been declared, announcing to manage works to prevent new virus infections, enforcing presence of related laws and regulations as a duty, organized video-selector of railway on 12th of May 2009, by presenting ways to get infected, prevention, UBRW’s all departments, branches and agencies have organized to prevent. On 29th of June 2009, we have processed and announced a guideline to act when a ‘’Passenger that is suspected with Influenza virus’’, and we made sure international and domestic rails are ready. On 29th of July, with the help of National Infectious Disease Center, we have organized a training to ‘’Early Prevention from H1N1 Virus Influenza Infection Counteract and Preparing Readiness’’ with having presenters from hospitals like Central and Branch rails joint clinic, physicians from branches and factory clinics, Wagon Depo in Ulaanbaatar, Passenger Service Ulaanbaatar Central Station, and produced 63 trainers.In Work of Making Sure of Readiness, on 10th of September 2009, by the order number 50 of Chairperson of Railway, solved 43 million tugrugs of Investment to making sure readiness of the medical and passenger service, saved some protection materials and other inventories. During the red alert additionally planned 156 million tugrugs, during whole phase of H1N1 virus infection UBRW had spent 204 million tugrugs. When looking at the spending: Medical equipments: 73781076 tugrugs, sterilizations and disinfectants: 23907969 tugrugs, protection materials: 27230300 tugrugs, vitamins: 62511518 tugrugs, educational advertisements: 10672525 tugrugs, others: 3369620 tugrugs.Conclusion:1. Incidents of H1N1 virus infection of people in covering area of UBRW’s Central Clinic and its branches railway’s joint clinics are less than National, Ulaanbaatar City, and Provinces that have railways.2. Children ages ranging from 0 to 4 and people from 20 to 49 years old with full ability to work are more likely to get infected.3. According to the research H1N1 Influenza virus incidents are higher in Bayangol and Bayanzurkh districts. The most incidents, which are registered from Bayanzurkh district’s sub districts, are I, III, IV are higher than other sub districts. In these sub districts, Ulaanbaatar Central Railway Station, and commercial centers like BARS Food Market and TOSA Market are located. Moreover 49% of the infected people live in apartments in which they don’t have central how water system, which cannot be denied that, had affected the spread of infections. 4. 96.5-99.15 of all infected people had headache, dry coughing, sneezing, discomfort, chest pain; 76.95 of all children had symptoms like diarrhea. Most patient’s chest X-ray diagnosed one of the two lungs have pneumonia. 60% of all the children and adult from 50 and over had a history of pain and diseases. But youths from 20-49 didn’t have any history of pain and diseases.5. It was effective to use medication tactics like immune activator and anti viral medications.6. In UBRW’s range there haven’t recorded any incidents that are more than 2 people from work place, school and family.7. To conclude (didn’t get laboratory test) from the first registered and dead patient first contaminated 1 person, which had treated in National Infectious Disease Center. And 1 person got lightly sick and got treated at home. If the patient got sick seriously and diagnosed positive, the closest 1 to 2 people have a possibility to be very likely to get contaminated.8. The latency stage of infection was 1 to 3 days and the average inpatient days were 10 days.

Vitamin D deficiency is a major health problem worldwide, especially in the elderly, so that an accurate assessment of its prevalence is essential for planning reliable healthcare policy throughout the lifespan. Purpose:The aim of the oncentrationofpresent study wasto assess the25-hydroxyvitamin D 25OHD) across different as well as the mild andmoderate deficiencies ages and genders.Methods:We searched the database of the local Laboratory Information System to retrieve results of 25OHD tests performed on the whole cohort of presumably Mongolian participants aged >22 yrs, who were referred to our laboratory in Gurvan Gal Hospital’s clinical laboratory, a 1-year period (January 2011 - January 2012). Results:Results for 25OHD testing were retrieved for 120 participants. No significant differences between females and males were observed for 25OHD values(20 [4-17.89]ng/ml versus 53 [4-20.06]ng/ml; p=0.3). A non significant variation of 25OHD values was also found by ANOVA analysis throughout 3 age cohorts (22-40, 41-60, >60 yrs), in both genders. In each age group, the values of 25OHD did not significantly differ between genders.Conclusions:We observed a high prevalence of vitamin D deficiency in a Mongolians. Lifestyle factors, including smoking, and physical activity, were significant predictors of serum 25-hydroxyvitamin D concentration.

Background:Laboratory test are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment and prevention of disease. Laboratory test gives 70% of information to get a right diagnosis. By some study, physiological factors such as diet, stress, exercise and sample collection techniques are influencing 32%-75% of test accuracy and reliability. That is why we want to studyhow nurses follow standard of sample collection techniques in UB.Our study conducted in 5 different hospitals. We observed nursesway of collecting sample from 150 patientsResult:Nurses did not identify patients ID in 80% of patients and did not ask test preparation and diet of 100%. They prepare necessary items to blood draw 95%. Also nurses did not fully follow blood draw standard in such way: hand sterilization, asepticize place of puncture and using bandage. Conclusion:Nurses don’t follow standard of draw blood from vein and did not clarifies patients test preparation. Pre-analysis process is the most influencing factor in the test result. So we have to train nurses to follow their standard of sample collection procedure.

Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.

Introduction. Cancer of unknown primary (CUP) is histologically defined as the presence of a metastasis of lymph node without detection of the primary tumor [1]. Approximately 3–15% of all cancers are designated as CUP [3. 4]. The diagnosis, treatment and monitoring of patients with laterocervical metastases of unknown primary involves a wide range of oncologic entities [5]. While we were studying patho-histological examination of cervical lymphadenopathy in Mongolian, werevealed unknown primary tumor. This is a goal of our study. Objectives of study are followings to differentiate whether primary lymphoma or metastatic cancer of cervical lymph node metastasis of unknown primary tumor and to reveal primitive origin of tumor using by basic and additional immunohistochemical markers.Goal.To determine the conclusive diagnosis in cervical lymph node metastasis of unknown primary origin by immunohistochemical techniqueMaterials and Methods. In this study, we examined immunohistochemically 30 cases of outpatient head and neck surgical unit of the National Cancer Center and dentistry and oral maxillofacial surgical unit of the State Central Hospital which were diagnosed as cervical lymphadenopathy. For immunohistochemical study, we applied an immunohistochemical panel in accordance with avidinbiotin- peroxidase complex method and used a basic and additional antibodies represented by CK(pancytokeratin), LCA, synaptophysin, chromogranin and HMB45. Result. In our study, there was 63.3% lymphoma, 36.7% metastatic cancer. Among them, there were 4 of digestive tract adenocarcinoma, 3 of squamous cell carcinoma /2-esophagus, 1-nasopharyngeal/, 2 of neuroendocrine tumor and 1 of melanoma.Distribution by age groups shows that 20-29 years were 4(13.3%), 30-39 years were 10 (33.3%), 40-49 years were 8 (26.7%), 50-59 years were 3 (10%), over60 years were 5 (16.7%). Gender distribution showed an increased incidence of males (56.7%, 17 cases) compared with females (43.3%, 13 cases).Conclusion: In our study, B cell lymphoma and digestive tract adenocarcinoma were the most common. In further, it is necessary to introduce an immunohistochemical method in patho-histological practice.