We present the fi rst 2 cases of cochlear implantation in Mongolia using “SONATA” type implant of “MED-EL” Company, Austria. CASE 1: A six years old, female had been diagnosed with bilateral congenital profound hearing loss and had been fi tted with hearing aids for 5 years and received little benefi t from her hearing aids and developed very poor speech and language, used lip reading and have had vocabulary of approximately 10 words. A radiological evaluation showed normal cochlea and auditory nerve. Cochlear implant team including speech therapists and audiologists based on the informed consent of patient’s parent decided that family able to participate in follow-up, speech habilitation programme. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. After 10 days of switch on of the speech processor the patient showed signs of initial hearing of loud sounds. After 5 months of Auditory Verbal Therapy the vocabulary increased up to 50 words. Hearing, cognition and responses are increasing simultaneously. CASE 2: A 2 years old female. Congenitally deaf in both ears. Fitted with hearing aid for 3 months before the surgery and there was no benefi t from hearing aid. Physically and mentally healthy. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. On 25th days of switching on of speech processor the patient showed initial hearing of loud sounds. Currently, after 5months of treatment her vocabulary is 2 short words and can recognize 4 syllabeles. She is very active, repeats actions and has open nature, feels comfortable with CI.

In modern society there is an increasing demand for oral communication in many professions. Professional voice users aren’t limited to teachers, ministers, salesmen, telemarketers, telephone operators, actors, singers, radio/TV announcers and attorneys. Problems reported by professional voice users are varied and may include hoarseness, voice breaks or cracks, voice loss, weak voiceand vocal fatigue. There are no studies done about the professional voice users in Mongolia. The purpose of this research that was to examine loading effect of work and additional loading factors. We were studied about comparison between normal groups and voice changes groups. Ninety seven professional voice users participated in this study. Half had singers group and half were found to haveteachers group. We used to the voice handicap index (VHI ) score and videolaryngoscopy and other general questionnaire.We studies voice change of the 97 professional voice users. We diagnosed voice disoeders by videolaryngoscopy and voice handicap index. We collected the data base in SPSS 22 and Microsoft excel programs.Major risk factor for voice change was use hormonal medicine. From 97 patients were predominantly diagnosed disease 14,4% reflux laryngit, 15.5% vocal fold nodule, 23.7% acute laryngit. Most of the patients had mild levels changes of voice handicap index.Voice disorders are common in professional voice users. So steroid use increase the risk of voice disorder in professional voice users.

Abstract: Demographical, social and cultural factors including population health, diagnoses, introduction of new treatment methods, capacity of the health organizations, enhancement of professional skills of medical practitioners, as well as drug efficacy affect the needs of drug. There are many methods used to estimate needs of drug. For example; Essential medicine list, medicines prescribed for specific illnesses and medicines consumed by norms. Moreover, there are two ways to estimate the demand of the essential medicines making basic comparisons of essential drug needs and morbidity indicators of the other countries in compliance with the recommendation of WHO.¹
Actual needs of the essential medicines for most common diseases and other medicines have determined by selecting from the records of inpatients by classification and amount as well as estimating the classification, amount and price of the medicines sold by pharmacy for the given period. This estimation reveals the temptation of the needs of the drug so that the amount of the supply will be determined by upcoming month, season and year. More importantly, It will not only benefit the classification, amount of the necessary medications but also it will estimate the budget for the certain period.
In the recent 9 years, the community acquired pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%.
Therefore, we have studied the needs of drug in the treatment actual consumption of medicine the CAP in children among 0 to 5 year old.
The research was referenced by the method of determining drug needs by consumption and morbidity indicators, other methods developed by scientists such as Hogerzell H.V., Jonathan D.Quick., James R.Rakin., Richard O.Laing., Ronald W.O.Connor., Andrew, Kobzari L.V, Dryomovo N.B, Glembotskaya G. T, Mnushko Z.N. Numerical data has been determined by average and standard deviation as well as maximum or minimum value employing variation analysis method. Result of the study Having determined the average number of CAP in children cases, temp of annual growth, fluctuations, statistical report of the last decade based on the actual medicine consumption for the treatment of CAP in children of all the participants (96 inpatients aged from 0 to 5 year) and disease prognoses; as result, it has been estimated the necessary drug needs for 27591-33869 CAP in children cases which will be treated in the hospitals of Ulaanbaatar city from 2019-2013.
There’s a tendency that approximately 31509 patients aged from 0 to 5 year are going to be hospitalized for CAP in children so that it’s estimated to require 1156848.1 MNT for the treatment.

Abstract: Respiratory diseases are the most common among the population of Mongolia, besides, the data regarding the pneumonia and chronic obstructive lung disease (COLD) among the community acquired pneumonia in children specially 0-5 year old has taken into much consideration when re- viewing the statistical report of 2010-2018 of Mongolia.¹
Looking at the details, as regards 2010-2011 there were 82 CAP case, which increased by 6.8%, but in 2011-2012, 48 cases were registered, which dropped into 3.7%. Again in 2012-2013, jumped by 2.6 % by reporting 33 cases. Then from 2013 to 2014, it has become 406 cases, increased by 31.8% whereas it added up to 848 cases registered in 2014-2015, which fell by 50.4%. 788 cases reported in 2015-2016 , rose by 94.7%. Then the figure decreased by 2.2%, only 36 reported cases in 2016-2017, again it soared up to 14.1% when 224 cases were registered in 2017-2018. In the last 9 years, the community acquired pneumonia among the 0 to 5 year olds in Ulaanbaatar city has increased by 10.4%.
Reviewing the Statistical Report of 2010-2018 of Mongolia, hospitalized cases of the children aged from 0-5 year old for CAP has gradually increased from 2010 to 2014; the total number of the above mentioned cases has become 8603 and the average increase was 13,1%.
In fact, the figure fell by 40% by reporting 8071 cases in 2014-2015 which whereas in 2015- 2016 there were 13073 cases, an increase of 108.3%. Then, in 2016-2017, the number has de- creased by 6.3% with 1604 reported cases. But in 2017-2018, registering 3260 cases, the rated jumped by 13.9%.²
In the recent 9 years, the pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%. Therefore we have studied the actual medicine consumption in the treatment of the CAP among 0 to 5 year old.
The research data was processed by cross-sectional study by employing retrospective analysis is used to randomly select actual drug consumption from the records of the inpatients who diag- nosed as CAP. Result of the study In the last 9 years, the CAP among the 0 to 5 year old children hospitalized in Ulaanbaatar city has increased by 15.7%.
The number of the inpatients diagnosed as the CAP has reached 21535 cases, which is increased by 6.2% in 2014-2018. Furthermore, there is tendency to increase pneumonia cases by 31509; it’s possible to have approximately an increase of 5.1% in the 2019-2023.
We have revealed 30 different types of medicines have been used for the treatment of the CAP after examining prescribed drugs.

BACKGROUND: Acute cholecystitis is defi ned mostly as bacteria from intestinal infl ammation to gallbladder. Sometimes the inflammation can occur when bacteria and viral can fl ow by blood and lymphus. Acute cholecystitis is leading the second place of acute abdomen. (1.2.3.7.8). The acute cholecystitis complication is not decreasing(4.5.6). The mortality is 0.5-0.8%(2.4.5.9). The acute cholecystitis is comparing with cholelith. Foreign scientists are recommending that fi rst 24-48 hours to treat by drugs, and after that if infl ammation is not healing to do cholecystectomy. In our country the acute cholecystitis is taking the place after acute abdomen and appendicitis. And also, acute cholecystitis morbidity is not decreasing and indication of cholecystectomy is not decided yet. OBJECTIVE: The main purpose of this survey is to study changing of acute cholecystitis depending on time Materials and Methods We studied 58 patients who had cholecystectomy in Surgical Department of The Central Clinical Hospital for State Special Clerks between 2005 and 2008. The result analyzed by SPSS-15.0 Program. RESULT AND DISCUSSION: The patients who was studied were 14 men (24.14%) and 44 women (75.86%). For the clinical symptoms of acute cholecystitis, the result has been occurred as following: the epigastria pain is 17 (29.31±5.9), around the right rib arch is 49 (84.48±4.7), the pain spread of the right shoulder blade is 20 (34.48±6.2), and the pain spread of the right shoulder is 33 (56.89±6.5), to have a fever 6 (10.34±3.0), vomit 10 (17.24±4.9), diarrhea 7 (12.06±4.2), thirsty 16 (27.58±5.8). The pain around right rib arch, pain spread right arm and shoulder, and thirsty are the clinical features that close to the features of scientist’s Alperovich B.I., Soloviev M.M., Saveliev V.S. Acute cholecystitis depending on time 0-24 hours catarrhal 5, phlegmonous 2, necrosis 1, 24-48 hours phlegmonous 4, necrosis 10, necrosis hole 2, 48-72 hours phlegmonous 10, necrosis 8, necrosis hole 3, above 72 hours phlegmonous 2, necrosis 5, necrosis hole 6. Acute cholecystitis starts above 24 hours. CONCLUSION: 1. The acute cholecystitis has been occurred 14 for men and 44 for women. Ate the age of 30-39. These cases were determined more then 31 percent. 2. For the clinical symptoms of acute cholesystitis, the result has been occurred as following: - the epigastria pain is 17, (29.31±5.9) - around the right rib arch is 49 (84.48±4.7) - the pain spread of the right shoulder blade is 20 (34.48±6.2), and - the pain spread of the right shoulder is 33 (56.89±6.5). 3. Under the period study of the acute cholecystitis, the pus, necrosis and perforation cases have been excessively occurred specially at 48-72 hours. 4. Under the comparison study between the acute cholecystitis and its period, the acute wall cholecystitis changes have been occurred specially at 24-48 hours.

Background: Headache is a common disorder among population. 47% of population of the world suffers from the primary headache. Due to the chronic lasting process of headaches, individuals lose productivity, get depression because of negative impact on people’s quality of life and economic status.
Headache disorders are amongst the top ten causes of disability in Europe [4]. Three of these (migraine, tension-type headache and medication-overuse headache) are important in primary care because they are common and responsible for almost all headache-related burden.
The burden is immense on workers, women and children in terms of missing work and school days. The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unraveled. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or tension-type headache (TTH) are professionally diagnosed and only 10% of those with medication-overuse headache (MOH).
There are no studies on the burden and disability assessment in patients with primary headache in our country, therefore a need for conducting this study. Goal: The burden and disability assessment in patients with primary headache in Mongolian adults. Methods and Materials: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old randomly were selected from four aimags of Mongolia and three districts of Ulaanbaatar city. They were visited by door to door calling and surveyed using the HARDSHIP and Migraine Disability Assessment (MIDAS) questionnaire. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program, and level of depression in headache present patients was determined by odds ratio (OR). Study methodology introduced at Ethical review Committee of “Ach” Medical University and approved in 2017 (№17/3/2). Results: There were 2043 participants 39.7% and 60.3% of them were men and women respectively. The mean age of them was 38.0±13.4 years. 57.4% (n=1173) of participants had headache, and 27.4%, 30.0%, 11.2% and 7.5% of them had migraine, tension-type headache, chronic headache and medication overuse headache respectively. 42% of participants with headache had the median duration of suffering 7 years (IQR=3-13 years). Out of 1173 participants with headache 20.7% had depression. 23% of participants with migraine had depression whereas 68.2 % and 47% of participants with chronic headache and medicine overuse headache had depression respectively. Participants with migraine were 1.85 (OR: 1.85, CI: 95%, 1.39-2.47) times, with chronic headache 3.40 (OR: 3.40, CI: 95%, 2.04-5.67) times and medicine overuse headache 3.31 (OR: 3.31, CI: 95%, 1,50-7.30) times more likely to suffer from depression compare to participants with no headache.
People with migraine loses their productivity 10.6 days/m, with chronic headache 19.7 days/m, with MOH 20.3 days/ m. According the MIDAS (migraine disability assessment) people with migraine has mild disability, while people with chronic headache and MOH had middle score of disability. Conclusion The prevalence of primary headaches is high among Mongolian adults. These headaches cause disability, impair work, study and daily activities, decrease life quality, and brings unrecognized socioeconomic burden.

Introduction. Stigma and discrimination against patients with mental illness is very common amongst the society. Therefore, this study aims to study the knowledge and understanding of mental illness and attitudes to patient with mental illness, among the general population.Goal. To assess the knowledge and understanding of mental illness and attitude to patient with mental illness among population of Ulaanbaatar city and compare its results with a similar research in carried out in 2002.Methods. The study was conducted in Ulaanbaatar city from February to April, 2008 and included 991 people aged over 18 years. The sample was selected from 30 micro districts of Ulaanbaatar city, The method of sampling was using primary dot in first step, sampling households in mid step and selecting people by using method of Sweden key from household in final step. The study used 30 item standardized questionnaires. Also there were 2 extra cards to read for respondents.Result. Among the respondents, 45% were males and 55 % females. Average age was 37 years. In view of identifying negative attitude of patient with schizophrenia, majority of respondents answered as “loony person” (n=136) and “mad person” (n=83). Conclusion. Although there was stigma amongst the study population, 66% of subjects who were involved in study could give right diagnosis in non professional level and were able to identify symptoms of mental illness suggesting that more than half of the sample studied had some knowledge of mental illness.

BACKGROUND Congenital and acquired hearing loss considered as the most common disability. According to the WHO report, 360 million people worldwide have disabling hearing loss, and 32 million of these are children. Severe to profound sensorineural hearing loss can be treated successfully with cochlear implants. Post implant Auditory Verbal Therapy/ Hearing Implant Rehabilitation is essential for the progress and better outcome. Multidisciplinary team approach, including ENT, audiologist, speech therapy, social worker, coordinator, caregiver /parent is required. The first clinical speech therapy department in Mongolia was established by the School of Dentistry, MNUMS based at the Maxillofacial Surgery Department of the MCNHC in 2006 (G. Ariuntuul, B. Bulgan, U. Azzaya). Where as the very first Cochlear Implanted child in Mongolia was received the surgery and audiology support by A. Ulziibayar, L. Byambasuren, B. Misheel, B. Narantya and the hearing implant rehabilitation treatment successfully conducted by the abovementioned speech team in 2009. Aim: To analyze current situation on speech therapy intervention for patients with hearing loss and deafness. METHODS Retrospective hospital data were collected based on the School of Dentistry, Speech therapy department between January, 2009- February, 2017. In total 70 patients’ information were retrieved for the study. Descriptive method is used for statistical analysis. RESULTS Out of 70 patients, attended speech therapy sessions 38 (54%) were males, 32 (46%) were females; where as 21 (30%) had congenital deafness and 28 (40%) acquired; 21 (30%) patients with hearing loss not known their causes of deafness. From the total of 28 (100%) cases with acquired hearing loss/deafness 11 (39%) patients cause of deafness is due to complication from infectios disease: meningitis.

Background: The primary headache disorders are one of the most common complaints among children and adolescents. Migraine and tension-type headache (TTH) are the most frequently types of primary headache, with prevalence of approximately 9.1% for migraine and 10–24% for TTH among children.
The aim of this study was to determine the 1-year prevalence and some risk factors of primary headache disorders in school-aged children. Material and Methods: A cross-sectional, school-based survey consisting of semi-structured questionnaires was administered to randomly select aged 6-11 years using stratified multistage cluster sampling during the period from April to June 2018. The questionnaire of primary headache was based on International Classification of Headache Disorders-III criteria. Statistical analysis was performed by using the SPSS, version 21. Student’s T-test, chi-square test and analysis of variance were used for comparisons when appropriate. The level of statistical significance was set at p<0.05. Results: We surveyed totally 635 participants; the one-year prevalence of all types of headache was 54.6%. Prevalence of migraine and tension-type headache was 3.0% and 5.4%, respectively. Elucidated biometric and socio-demographic risk factors showed statistically significant difference in prevalence of migraine: type of household, life situation and residential quarter. Conclusion Our study found that frequency of prevalence of primary headaches among the school-aged children is relatively high and comparable with other countries.

Introduction: Rongalite have many names, the trade name for sodium hydroxymethylsulfinate also sodium formaldehydesulfoxylate. It causes serious side effects to human body and is forbidden to be used as food additives by law. It is still frequently used illegally in rice and flour products. Based on this study, we determination rongalite level in some friut widespread of in our country. The study was done materials used in Lingonberry, Blueberry, Hippophae, Blackcurrant fruits collected in Khuvsgul. To determine rongalite was followed by protocol to sanitation-laboratory of food of the school of social of health in MNUMS used for NC-860 Universal Food Safety Analyzer. The concentration in sample that were measure to 153.88- 213.85 mg/kg of Lingonberry, Blueberry, Hippophae, Blackcurrant fruits weight. Materials and methods : The study was done materials used in a Lingonberry, Blueberry, Hippophae, Blackcurrant fruits collected in Khuvsgul. To determine rongalite was followed by protocol to sanitation-laboratory of food of the school of social of health in MNUMS used for NC-860 Universal Food Safety Analyzer. Weigh accurately 5.0 g of the fruit in a plastic extract bottle, add 20 ml of distilled water, extract for 10 min by centrifugated. Than filtrate into 6 time respectively test tubes through 0.45 μm membrane using remove the color. Rongalite determined in use a disposable test tube, add 1 drop of oxidizing reagent. Amount of rongalite used for NC-860 Universal Food Safety Analyzer. Result and discussion Based on the obtained result, the maximum concentration observed in Blueberry was 213.85 mg/kg, and the minimum concentration observed in Hippophae was 153.88 mg/kg, the concentration observed in Lingonberry was 192.8 mg/kg, the concentration observed in Blackcurrant was 155.29 mg/kg of contained weight respectively. The difference of rongalite concentrations in wheat powder and rice powder was 0.41 mg/kg in China. Identified to the result was higher than other research.