Introduction: Outpatients health care service or ambulatory care is can support the most (80-85% of all) health services except the admission and emergency and intensive care of severe patients. WHO is offering the health care services provided to patients on an ambulatory basis, rather by admission to a hospital or other health care facility in developing countries. The outpatient health services quality may be diminished in my country since 1990 and also outpatient health care services did not expanded because of too much concerning about hospital admission. Goal of study: To evaluate the Achtan Elite Clinical Hospitals outpatient- policlinic health service in 2006-2007 years and to improve the outpatient- inpatient services correlation and management. Objectives: 1. To make analyses outpatient-policlinic health service result. 2. To find out outpatient areas workloads. Methodology of study: We prepared special questionnaire and tried to evaluate a daily normal workloads. We used Statistical SPSS-12 program is used for statistical analyses. Results of study: Achtan Clinical hospital served 3899-4364 inpatients for admition in hospital, 38327-39675 outpatients in 2006-2007 years. The most 30308- 35959 outpatients were for diagnostic visit for doctors and rest people visited for preventive care. If compare our workloads with state clinical hospitals, we provide 11.9%-14.3% health service of state hospitals workloads. Gastroenterology, cardiology and neurology cabinets workloads are always higher than other cabinets in 108% -124%. In contrast traditional medicine, pediatric, neurosurgery and psychiatrist cabinets did not perform (55-75%) their normal workloads. Discussion: According to ambulatory-outpatient health, services study shows that necessity of opening the family doctor centered local outpatient care in big cities like Ulaanbaatar. There will need 10-15 family doctors and 8-10 specialized doctors to serve 20000-25000 residencies or 4000-5000 families. Laboratory, rehabilitations, dispensary, health education department of preventing most infectious diseases including tuberculosis, psychiatric and traumatic disorders preventing programs will be able to maintain. When we change the policy of administration and management of outpatient health services than community, based prevention will be able to follow. Conclusion: 1. There is a necessity of expanding and management of renewing out and inpatient clinic. Which provide 80-85% of all the medical help and service. 2. The relationship of out and inpatient clinic and their activity risk and resource are need to determine. All these mentioned fi nding show that health administrative has to perform well-targeted study. 3. To fi nd out normal working load is main problem of health management. In our predictive study-shows in internal and neurological cabinets load can be 25 people per day, 15-20 for surgical and ophthalmological, 10-15 for urology and gynecology cabinets.

Aim of this study was to evaluate the effectiveness of weight loss intervention in overweight and obese patients with newly diagnosed type 2 diabetes mellitus (T2D).92 overweight and obese subjects (42 men and 50 women), aged 32-56 years, with recently diagnosed type 2 diabetes were enrolled to the prospective cohort study. A 6-month counselingbased intervention was conducted between December 2011 and June 2012. Participants were Mongolian and received education sessions on healthy lifestyle guidelines including nutrition and physical activity in small groups. Before and after intervention, body weight (kg), body fat (%), waist and hip circumferences (cm), blood pressure (mm Hg), fasting blood glucose (mmol/l), HbA1C (%), total cholesterol (mmol/L) and triglyceride (mmol/L) were measured.80 out of 92 (86.9%) overweight and obese patients with T2D (BMI 31.57±4.2) completed weight loss intervention. Results of this study before and after the intervention showed mean body weight 84.41±13.08 vs 80.11±12.42, p<0.0001; BMI 31.57±4.2 vs 29.87±3.72, p<0.0001; waist circumference 104.18±10.51 vs 99.78±8.52, p<0.0001); hip circumference 107.04±8.66 vs 105.38±7.79, p<0.01; WHR 0.96±0.07 vs 0.94±0.05, p<0.0005; body fat 36.19±5.64 vs 34.26±6.57, p<0.0005; systolic blood pressure 133.03±22.5 vs 127.54±17.5, p<0.01; diastolic blood pressure 81.18±13.14 vs 77.61±11.03, p<0.05; fasting blood glucose 11.57±4.06 vs 7.99±2.64, p<0.0001; HbA1C 8.45±2.70 vs 5.95±1.70, p<0.0001; and total cholesterol 3.87±1.05 vs 3.15±0.96, p<0.0001 were improved significantly, except triglyceride 2.11±0.82 vs 1.73±1.8, p=0.0519. Thus results of the study showed an average weight loss of 4.3 kg and a significant decrease in BMI, percent body fat, and waist and hip circumferences, waist to hip ratio at 6 month. Significant reduction found in levels of fasting glucose, HbA1c and total cholesterol in blood after intervention, however no significant change found in blood level of triglyceride. Systolic and diastolic blood pressures were reduced significantly.Weight reduction of 5.1% of body weight in overweight and obese subjects with type 2 diabetes by the lifestyle intervention for 6 months resulted in significant reductions in total, abdominal and trunk adiposity and reduced blood pressure and improved glycemic control and dislipidemia.

Background: Population of a significant number of countries in the world use drinking water high in arsenic content. Asia is a leading region in the world by the endemic arsenic prevalence and countries such as India, Bangladesh, China and Taiwan have high prevalence of arsenic. The fact that in neighboring China, namely, in Inner Mongolia, the number of cases of neuropathy and skin cancer has been increasing, amplifies the necessity for such studies. It is essential to conduct further research in order to identify arsenic content in drinking water throughout the country.Goal: The survey aims at studying arsenic content in drinking water and mapping arsenic prevalence by aimags and soumsMaterials and Methods: The survey was conducted nationwide –21 aimags and urban areas, in total, arsenic content in drinking water was studied in 291 soums in 867 wells. Arsenic content was identified with a test kit developed by Mahidol University, Thailand. Results: Out of 867 well water samples from 21 aimags and Ulaanbaatar studied for the survey, 91 or 10.5% contained arsenic. Arsenic was found in well water of all aimags except Bulgan, Zavkhan, Orkhon, Selenge and Huvsgul aimags. Nationwide, average arsenic content in drinking water is 0.014+ 0.003mg/l. Highest arsenic content was found in Dornogobi (53.9%), Dundgobi (31%) and Sukhbaatar (27.3%) aimags. Although average arsenic content in drinking water in selected wells in Tuv, Gobisumber, Dornogobi, Gobi-Altai, Dornod, Sukhbaatar and Dundgobi aimags contains 1.2-5 times more arsenic than UST-900-92 standard and WHO recommended content. Out of all studied samples, water from well #3 in Khatanbulag soum, Dornogobi, contained 0.07mg/l arsenic which is the highest – 0.065mg/l more than UST-900-92 standard and WHO recommended content.Concliusions:1. Out of 867 well water samples 10.3% contained arsenic.2. Arsenic content in drinking water nationwide is 0.014+-0.003mg/l. The highest arsenic content is recorded in Khatanbulag soum, Dornogobi – 0.075mg/l.

GoalAim of this study was to evaluate the effectiveness of weight loss intervention in overweight and obesepatients with newly diagnosed type 2 diabetes mellitus (T2D).Materials and Methods92 overweight and obese subjects (42 men and 50 women), aged 32-56 years, with recently diagnosedtype 2 diabetes were enrolled to the prospective cohort study. A 6-month counselingbased interventionwas conducted between December 2011 and June 2012. Participants were Mongolian and receivededucation sessions on healthy lifestyle guidelines including nutrition and physical activity in smallgroups. Before and after intervention, body weight (kg), body fat (%), waist and hip circumferences(cm), blood pressure (mm Hg), fasting blood glucose (mmol/l), HbA1C (%), total cholesterol (mmol/L)and triglyceride (mmol/L) were measured.Results80 out of 92 (86.9%) overweight and obese patients with T2D (BMI 31.57±4.2) completed weightloss intervention. Results of this study before and after the intervention showed mean body weight84.41±13.08 vs 80.11±12.42, p<0.0001; BMI 31.57±4.2 vs 29.87±3.72, p<0.0001; waist circumference104.18±10.51 vs 99.78±8.52, p<0.0001); hip circumference 107.04±8.66 vs 105.38±7.79, p<0.01;WHR 0.96±0.07 vs 0.94±0.05, p<0.0005; body fat 36.19±5.64 vs 34.26±6.57, p<0.0005; systolic bloodpressure 133.03±22.5 vs 127.54±17.5, p<0.01; diastolic blood pressure 81.18±13.14 vs 77.61±11.03,p<0.05; fasting blood glucose 11.57±4.06 vs 7.99±2.64, p<0.0001; HbA1C 8.45±2.70 vs 5.95±1.70,p<0.0001; and total cholesterol 3.87±1.05 vs 3.15±0.96, p<0.0001were improved significantly, excepttriglyceride 2.11±0.82 vs 1.73±1.8, p=0.0519. Thus results of the study showed an average weight lossof 4.3 kg and a significant decrease in BMI, percent body fat, and waist and hip circumferences, waist tohip ratio at 6 month. Significant reduction found in levels of fasting glucose, HbA1c and total cholesterolin blood after intervention, however no significant change found in blood level of triglyceride. Systolicand diastolic blood pressures were reduced significantly.ConclusionWeight reduction of 5.1% of body weight in overweight and obese subjects with type 2 diabetes bythe lifestyle intervention for 6 months resulted in significant reductions in total, abdominal and trunkadiposity and reduced blood pressure and improved glycemic control and dislipidemia.

Justification: Iodine is a micronutrient essential for human health. 92% of the required iodine human organism obtains with food. One of methods to supply the required amount of iodine is the use of iodised salt. The overall goal of our study was to determine the actual consumption of iodised salt by households. Materials and Methods: Samples of salt consumed by 20173 households from five regions (Western, Mountainous, Central, Eastern regions and Ulaanbaatar city) of Mongolia were collected and their iodine contents were determined according to MNS 5168:2002. Results: Out of the total analyzed salt samples, 19.1 % were non-iodised, 2.8% had low iodine content, 77.5% had appropriate level of iodine and 0.6% had high level of iodine.
When the salt iodine contents were evaluated by the country regions, it was revealed that the households in Western (31.4%) and Mountainous (20.57%) regions consumed salt that was not iodised. 84.5% of the Ulaanbaatar city households consumed salt with appropriate level of iodine. Conclusions
1. 19.1 % of the surveyed households consume non-iodised salt, 2.8% consume salt with low iodine content, 77.5% consume salt with appropriate level of iodine and 0.6% consume salt with high level of iodine.
2. The iodine level is appropriate in 84.5% of salt consumed by Ulaanbaatar city households.

Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.

BACKGROUND Recent studies show malocclusion rate among Mongolian population is increasing year by year. Malocclusion has a strong relationship with dental caries and its complications. Cephalometric measurement norms are one of the important tools that are used for diagnosis and treatment of malocclusions. Nowadays there are no cephalometric linear measurement norms among Mongolian population according to age and sex. Background of this study was to determine cephalometric linear measurement norms among Mongolian children. METHODS Total 161 children of 6 years old were participated in this study and 79 (36 male and 43 female) children with normal occlusion were selected to determine cephalometric linear measurement norms. Winceph 11.0 program is was used for measurements. RESULTS From all participants’ children with normal occlusion occupied 49% (79 children). Result of measurement results shows no significant statistical differences between males and females. CONCLUSION These cephalometric linear measurements norms will be standard norms for Mongolian children and it is very important tool for orthodontic practice.

Background: Pneumonia is one of the leading causes of morbidity and mortality in children around the world. Annually, it’s estimated about total of 120 million cases of pneumonia occur in children under the age of five around the world and about 2 million of them end in mortality. In 2017, respiratory diseases constituted 31.3% of all diseases in children under the age of five in Ulaanbaatar city. 268 cases of respiratory diseases occur in every 1000 children, making it the leading disease in children of that age group. Sonographic examination has several advantages including lack of radiation, accessibility, portable (can easily bring it next to the patient’s bed), cost effective, and can be used repeatedly on the patients. To our knowledge, currently in Mongolia, there are no published research materials on sonographic examination in children with pneumonia. Given, the lack of study, increased rate of pneumonia and advantages of ultrasonographic, the present study was performed to detect lung ultrasound sign of pneumonia and determine the specificity and sensitivity of lung ultrasound and X-ray. Methods: The study used cross-sectional studies of analytical study. 379 inpatient children aged between 1 month to 14 years old who are in the children’s hospital of Bayangol district between 1st of September 2019 to 1st of December 2019 participated in the study. Procedures included collection of questionnaires from the parents or the guardians, random collection of data from the patients’ history, and assessment of results from ultrasound and X-ray examination. The study used Stata software to analyze the statistics. Results: 56% or 210 cases showed decreased echogenicity in the ultrasound examination. Incorporated B line sign (р=0.001),, decreased echogenicity in the consolidation (р=0.001), and presence air positive bronchus (р=0.001), are shown to the major sign of pneumonia in ultrasound examination. Conclusions In pneumonia, following signs are present in lung ultrasound: Unilateral B-lines, consolidation, hypoechoic, irregular shaped consolidation, positive air bronchogramm sign in lung. From the results of our research, we discovered diagnosis sensitivity of pneumonia in ultrasound is 85%, specificity of pneumonia in ultrasound is 87%, sensitivity of pneumonia in Х ray is 78%, specificity of pneumonia in Х ray is 84%.

IntroductionThe trace elements selenium is a constituent of the antioxidant enzyme glutathione peroxidase. Becauseit boosts the body’s antioxidant capacity, selenium is thought to have some ability to control cell damagethat may lead to cancer. Selenium low status has been linked to increased risk of various diseases, suchas cancer and heart disease.GoalInvestigate serum selenium level of adult mongolians and conduct age and gender coparartive analysisof the serum selenium content.Materials and MethodsCross sectional study was performed among the 2339 apparently healthy Mongolians of both gendersaged ≥18 years. In the study were used questionnaire and biochemical methods. Blood samples werecollected from all subjects and serum selenium concentration was measured by atomic absorptionspectrophotometry method using thermo fisher scientific analyzer.ResultsThe mean and confidence interval of serum selenium level in adult Mongolians was 0.78 μmol/l (95%CI0.77-0.79) and there was no significant difference between genders. Thus the mean was 0.77 μmol/l(95%CI 0.76-0.80) among women and in men it was 0.78 μmol/l (95%CI 0.76-0.80). Data analysisrevealed that older age group individuals were at risk of lowered serum selenium level. In particular,the oldest age group of over 60 years (females: 0.74 μmol/l, 95%CI 0.70-0.77; males: 0.68 μmol/l,95%CI 0.64-0.71). The difference in selenium status between age groups was statistically significant inboth sexes. The overall prevalence of serum selenium concentrations indicative risk of deficiency was59.7%, with no significant differences in the prevalence by genders. Survey findings revealed that riskof selenium deficiency had statistically significant difference between age groups among the surveyedmen.Conclusion: The mean value of serum selenium in adult Mongolians was 0.78 μmol/l and there was nosignificant difference between genders.

BACKGROUND: According to the United Nations, drug reports 2016, 250 million people aged 15 to 64 an estimated 29 million of them have used drugs and narcotics. The United nations states that the drug and narcotic manufacturing have increased by three times in east 15 years. Mongolia is located between Russia and China that are the most drug used countries in the world and it can increase the risk of drug usage in Mongolia. OBJECTIVE: Study to knowledge and attitude about drugs and narcotics among the high school, college and universities students in Ulaanbaatar. METHODS: The research was conducted among the school, college and universities students and the analytic research method was used in our research. 176 middle and high school students, 215 university students and 70 college students from morning classes were participated in the survey. The survey research was used method of collecting information and materials about the drug usage and narcotics. SPSS 17 was used for statistical analysis. RESULTS: The highest point was 16 (n=1) and lowest point was 0 (n=16) and the knowledge of drugs among the students was 8.14. Results releated that 7.8% (n=36) of students have enough information about the drugs and narcotics, 62.9% (n=261) of students did not have enough information and 29.3% (n=135) of them have informed moderately. CONCLUSIONS: Exploring the knowledge about drugs and narcotics among the students, 7.8% of them have enough information, 62.9% of them did not have enough information and 29.3% of them have informed moderately