Cancer remains the second leading cause of population mortality in the last 10 years in Mongolia. In 2009, the overwhelming majority (78.3%) of new cancer cases were diagnosed in late stages (III and IY) and 67.06% of cancer patients survived for less than a year after the diagnosis. Pain is the first symptom of cancer in 20-50% of all cancer patients, and 75-90% of advanced or terminal cancer must cope with chronic pain syndromes related to chemotherapy, failed treatment, tumor progression, and associated pathology in tumor bearing tissue. Pain limits daily activity in 41% of patients reporting mild to moderate pain and in 94% of patients reporting moderate to severe pain, leading to greatly diminished quality of life. Drug therapy controls cancer pain in 70-90% of patients with pain follows the World Health Organization’s ladder approach for pain relief. Multiple factors may contribute to dose escalation in cancer patients, including changes in endogenous opioid function, disease progression, and development of opioid-induced hyperalgesia and particularly at high doses, can be associated with severe, sometimes debilitating side effects, including somnolence, mental confusion, and especially constipation. Effective control of cancer pain can now be achieved in a high proportion of patients with rigorously applied pharmacologic treatment, reducing the need for more demanding invasive procedures. Intrathecal neurolysis is a time-tested procedure that has important indications for drug resistant severe pain. Therefore, we aimed to study the effectiveness of spinal neurolytic block in patients with cancer pain. We studied patients who suffered from pain with advanced cancer of coli uteri in ‘Hope’ hospice and Achtan Clinical hospital of Ulaanbaatar Mongolia from 2011-2012. The study participants were dvided into two groups and observed 10 weeks. In group I morphine therapy oral and injectable and the patients of group II spinal neurolytic block performed with alcohol in patient using oral morphine received. The pain was assessed by Wong Baker Score before and after celiac plexus block and also the functional score was assessed by Karnofsky performance scale. The result of the study confirm that spinal neurolysis is significantly reduced intensity of the pain, morphine consumption, incidence of drug-induced undesirable side effects and physical performance. The procedure has proved to be very useful in alleviating segmental pain. Pain relief was obtained in 78 percent of the patients, with complications in 2 percent. The technique is the standard subarachnoid puncture and injection of absolute alcohol in small increments up to 1 cc. per interspace.

Cancer remains the second leading cause of population mortality in the last 10 years in Mongolia. In 2009, the overwhelming majority (78.3%) of new cancer cases were diagnosed in late stages (III and IY) and 67.06% of cancer patients survived for less than a year after the diagnosis. Pain is the first symptom of cancer in 20-50% of all cancer patients, and 75-90% of advanced or terminal cancer must cope with chronic pain syndromes related to chemotherapy, failed treatment, tumor progression, and associated pathology in tumor bearing tissue. Pain limits daily activity in 41% of patients reporting mild to moderate pain and in 94% of patients reporting moderate to severe pain, leading to greatly diminished quality of life. Drug therapy controls cancer pain in 70-90% of patients with pain follows the World Health Organization’s ladder approach for pain relief. Multiple factors may contribute to dose escalation in cancer patients, including changes in endogenous opioid function, disease progression, and development of opioid-induced hyperalgesia and particularly at high doses, can be associated with severe, sometimes debilitating side effects, including somnolence, mental confusion, and especially constipation. Effective control of cancer pain can now be achieved in a high proportion of patients with rigorously applied pharmacologic treatment, reducing the need for more demanding invasive procedures. Intrathecal neurolysis is a time-tested procedure that has important indications for drug resistant severe pain. Therefore, we aimed to study the effectiveness of spinal neurolytic block in patients with cancer pain.We studied patients who suffered from pain with advanced cancer of coli uteri in ‘Hope’ hospice and Achtan Clinical hospital of Ulaanbaatar Mongolia from 2011-2012. The study participants were dvided into two groups and observed 10 weeks. In group I morphine therapy oral and injectable and the patients of group II spinal neurolytic block performed with alcohol in patient using oral morphine received. The pain was assessed by Wong Baker Score before and after celiac plexus block and also the functional score was assessed by Karnofsky performance scale.The result of the study confirm that spinal neurolysis is significantly reduced intensity of the pain, morphine consumption, incidence of drug-induced undesirable side effects and physical performance. The procedure has proved to be very useful in alleviating segmental pain. Pain relief was obtained in 78 percent of the patients, with complications in 2 percent. The technique is the standard subarachnoid puncture and injection of absolute alcohol in small increments up to 1 cc. per interspace.

IntroductionDigestive system diseases are accounted in 4th place of the causes of mortality that are might caused by Mongolian climates and the features of food nutrition. It is a very important to obtain the natural herbal drug which has less side effect, use in medical practice for an appropriated disorder. Therefore we are put an aim of obtain a new drug from Sanguissorba officinalis L. for the treatment of diarrhea. This herbal plant grows in botanical and geographical provinces such as Khangai, Khentii, Khuvsgul, Mongol Daguur and widely distributed in Mongolia. Sanguissorba officinalis L. containes tannin substance up to 20%. Rhizome, herbs, flowers of Sanguissorba officinalis L. are widely used for the Mongolian, Tibetan, Russian, German, Korean, Poland, Hungarian traditional medicine to treat diarrhea, gastrointestinal disorders and haemostatic. This study and research work was done by Pharmaceutical Technology and Management Department of School of Pharmacy, HSUM.GoalThe aim of the study is to solve the problem of technology to obtain a tablet formulation from Sanguissorba officinalis L.Materials and MethodsWe collected and dried the flowers of Sanguissorba officinalis L. in Kherlen soum, Dornod province on August of 2010, 2011 and 2012. Choice of the optimal extragent, suitable extraction method was defined by I.A.Muraviev, U.G. Pshukov methods. The fraction of granules were determined using the method by Kozein, the bulk density of granules was determined method by Lusy Wan Cheng, to obtain tablets used by wet granulation method, to establish quality criteria of liquid extract and tablets by Mongolian National First Pharmacopeia, and the statistic analyses were done by SPSS-17 programme, using t-criteria of Student Fischer.ResultWe had extracted liquid extract from flowers of Sanguissorba officinalis L. and it has been extracted by repercolation method German pharmacopeia modification. The technological parameters of liquid extract are the main important index to calculate the extragent correctly, to establish the material balance exactly, to extract the process efficiently, to develop technological regimentation and to base account of economical benefit. We determined the technological parameters as the optimal extragent is 40% ethanol; the effective extracting method is repercolation method German Pharmacopeia modification. For the development of tablets by wet granulation method from liquid extract using various binders and choose the optimal bender was mix starch and methylcellulose past. Tablets from Sanguissorba officinalis L. was standardized by such criteria, as the amount of biologically active compound, appearance, hardness, friability, average weight, weight variation, disintegration, dissolution, amount of heavy metals and microbiological contamination by Mongolian National First Pharmacopeia.ConclusionThe result of the study was done the technological parameters of liquid extract of Sanguissorba officinalis L. such as the optimal extragent, the effective extracting method. As the result of determining these parameters, it has much practical significance for establishing the technological condition to extract the biological active compounds completely from flowers of Sanguissorba officinalis L. In the result of the study to obtain tablets from fluid extract of Sanguissorba officinalis L. has been developed and the quality criteria has been defined.

Introduction. The survey was conducted to establish the midterm evaluation of the National Program on NCD Prevention and Control, and to establish baseline data for a health project funded by the Millennium Challenge Account (MCA).Goal The goal of the survey was to determine the prevalence alcohol consumption pattern among Mongolian adults using WHO-approved methods, and to inform on NCD and injury control activities.Objectives:To compare the current prevalence of alcohol consumption to that identified in the previous STEPS survey. Alcohol consumption patterns, frequency of drinking and risks associated with alcohol consumption will be studied according to gender, age and place of residence of the survey respondents.Materials and MethodsThe cross-sectional survey used WHO STEPS survey methodology adapted to the countries specifics. A total of 5638 randomly selected 15-64 year-old Mongolian residents of both sexes from 36 soums of 20 aimags and 6 districts of Ulaanbaatar city participated in the survey. The survey data was fully collected using small handheld computers (PDAs). Because the data was comprised of only a sample of the large population, it was necessary to weight the data, Thus sample weighting and adjustments to correct the differences in the age-sex distribution of the sample compared to the largest population were performed. Data analysis was conducted using EPI INFO version 3.5.1 using appropriate methods for the complex sample design of the survey. Outcome measures (prevalence and mean variance) and differences between groups (age, gender and urban\ rural groups) were calculated with 95% confidence intervals (95%).Results:34.2% of Mongolian adults did not use alcohol in their life-time and 65.8% of them used alcohol to some extent. The prevalence of binge drinking was 39.7% in men and 15.1% in women, and binge drinking was 2.5 times more common in males compared to females.

Tuberculosis disease is directly proportional to a country’s socio-economic situation and standard of living. Studies have shown that in Mongolia the inflation, unemployment, poverty and migration that have emerged as a consequence of the socio-economic changes in 1990s have influenced the spread of the disease.The Global Fund to Fight AIDS and Tuberculosis Project was initiated by the UN and launched in our country in 2003. In relation to an expected completion of the project in 2016, the need has been determined to include the funds required for AIDS and tuberculosis (TB) treatment into the state budget and, therefore, the necessity to conduct a detailed study of TB drug usage to validate this need has become the basis of this research.[3,5,6] Materials and methods: Patient history of 200 inpatients in (NCCD). Registration of drug expenditure of pulmonary tuberculosis and multi-drug resistant tuberculosis (MDRTb) and statistic survey data.As WHO recommended determining drug consumption by disease and mathematic statistic method. Purpose:Multi-drug resistant drugs tuberculosis used in the treatment of estimated needs, and to be determined by the main anti-tuberculosis drug spending.Results: 1. 50 patients diagnosed as MDRtb by the NCCD used 9 main types of drugs, Out of these 5 were most widely used. 2. 1,211,700,0±546,008,9million was spent on treatment of MDRtb in inpatient facilitiesКey words:Multi-drug resistant tuberculosis

INTRODUCTION: Urinary tract infections among the most common bacterial infectious diseases encountered at all ages. Escherichia coli are being the etiologic agent in 50–80%. Therefore, it is an important public health problem. E.coli causing urinary tract infections express pilli, fimbriae and others adherence virulence factors. GOAL: To detect the some adherence virulence factors of Uropathogenic Escherichia coli (UPEC) in Ulaanbaatar, Mongolia MATERIALS AND METHODS: A total of 76E.colisampleswere collected. These samples were positive bacteriological examination of urine, performed at the bacteriological laboratory of the State Central Third Hospital and State Central First Hospital, Ulaanbaatar, Mongolia. The biofilm formation was evaluated by the growth rate of E.coli on plastic surface.The detection of the virulence factors type 1 fimbriae (fimA gene) and P-fimbriae (papC) was performed by multiplex PCR using gene specific primers.Curli expression was determined by using congo red agar. RESULTS: The evaluation of bacterial biofilm formation using 96 well plates showed 40 negative (52.6%), 32 weak biofilm (42.1%) and 4 moderate biofilm (5.3%) formation for E.coli and no strong biofilm forming strain was detected. The cell surface protein (curli) was detected by Congo red agar. The result was 71% positive for studied E.coli strains. The detection result of pili genes by multiplex PCR showed that fimH gene detected for 73 (96.1%) and papC gene detected for 18 (23.7%) E.coli cultures. CONCLUSION: Almost half of surveyed Uropathogenic E.coli isolated in Ulaanbaatar, Mongolia had ability of biofilm formation and it has been determined by the bacterial surface protein (curli), which is one of bacterial adherence factors, may cause biofilm formation.

Introduction: According to the statistical data of health organization 43% of all diseases and 60% of all deaths are due to chronic diseases including cardiovascular diseases, diabetes mellitus and cancer. Many factors contribute to the wide spread of noncommunicable diseases (NCDs)1. As defined in the World Health Report 2002, many common risk factors such as unhealthy diet, physical inactivity, smoking, alcohol use, overweight, raised blood pressure, raised total cholesterol levels and blood sugar are the most prevalent risk factors among the world population. In conclusion, the Mongolian NCD STEPs survey of 2006 revealed that 9 in every 10 people had at least one risk factors for developing NCDs. One in every 5 people had three and more risk factors for developing NCD3. However, partial studies of NCDs, which are dominant in Mongolia, had been conducted previously; the possibilities of wide use of the results are limited and those studies covered only adult people. So it is very important to evaluate knowledge about nutrition and food, tendency and practical experience about life style, activity of motion and use of food among the children.Objective: The goal of the study was to determine the prevalence of risk factors for NCDs among schoolchildren and to develop recommendation and suggestion for prevention of non communicable diseases.Materials and Methods: The survey covered 1504 students, studying in 20 middle and high schools, which are located 5 districts of UB, and was conducted by cross-sectional methods using questionnaire and anthropometric measurements (height, weight and BMI).Results and Conclusion: 31.3% of surveyed population did not consume any serving size of fruits per day, 68.7% consumed less than 5 serving sizes. The second common source of fat was fatty meat and butter. The prevalence of tobacco use was 6.1% of the surveyed population. School children do sedentary work, which has low energy consumption, after class. They watch TV for 3.53±1.24 hours and work on computer 2.83±1.07 hours a day. Percentage of the students who involved in some kind of sports activities is 71.2%, whereas 28.8% of them do not do any physical exercise. The reason why they do not participate in sports activities was determined as follows: do not have enough free time 37.2%, do not like sports 5.3%, due to high fees 35.1%, and inconvenient locations of sport facilities 18.2%. Although the laws, resolutions and regulations, supporting public sports are enough, the structure and action of the units that implement, evaluate and control these laws and regulations are weak.

IntroductionClimate change has already been started in Mongolia. The frequency of natural disaster such as drought, zud disaster, snow storm, hot and cold extreme weather, and earthquake has increased every year. As per daily information of meteorological stations, annual air temperature has been increased since 1960. Children is more sensitive in varies environmental impacts compared with adults and adverse effects caused by climate changes can be remained in all lives and it can be irreversible. Relation between climate change and children’s health is one of the issues which have not been studied yet. The purpose of this study was to investigate relationship between respiratory diseases of children and climate change as well as some air pollution parameters.Materials and MethodsStudy was carried out by cross-sectional study design. According to the regional climate classification of Mongolia, Zavkhan, Selenge, Dornod and Umnugovi provinces was selected as a target area of the study. The relationship between respiratory disease of children and climate change as well as some air pollution parameters were analyzed based on statistical data of Health Departments and Family doctors’ documentation of those provinces for prevalence and incidence of respiratory disease among the children aged 0-16 and daily information of climate parameters such as air temperature, air pressure, relative humidity and precipitation status taken from selected provinces Meteorological Departments and data for air quality basic parameters (SO2, NO2, CO2, PM 10) taken from Air Quality Department of Ulaanbaatar city.ResultsRespiratory diseases among the target ages were registered highly (70.7%) in age of 0-5 years. According to the comparison results in incidence rate of respiratory diseases by region, upper respiratory tract diseases (J09-J18) and lower respiratory tract diseases (J20-J22) were registered in Umnugovi aimag (254.75 and 50.42cases per 10000 children)which belong to very dry and warm regions and Dornod aimag (121.62 and 26.11 cases per 10000 children) which belong to dryish cold regions in 2010. Respiratory tract diseases (J09-J18, J20-J22) were correlated weak indirectly with average air temperature and minimum average air temperature. It was correlated weak directly with wind speed and air pressure. Respiratory tract diseases (J09- J18, J20-J22) were correlated directly with SO2 concentration in air (r=0.269, p>0.001) and NO2 (r=0.286, p>0.001).ConclusionClimate change and air pollution could be influenced on the increase of morbidity of respiratory tract infections. Some air pollution parameters such as SO2, NO2 and PM2.5 and air temperature, air pressure, relative humidity and wind speed are the causes of respiratory tract infections among the children aged 0-16.

Epidemiological situation of taeniasis in Mongolia was assessed based on mitochondrial DNA identification of the parasite species. Multiplex PCR was used on a total of 194 proglottid specimens of Taenia species and copro-PCR and loop-mediated isothermal amplification (LAMP) assays were utilized for detection of copro-DNA of 37 fecal samples from taeniasis patients submitted to the Mongolian National Center for Communicable Diseases (NCCD) from 2002 to 2012. In addition, 4 out of 44 calcified cysts in beef kept in formalin since 2003 were evaluated for histopathological confirmation of cattle cysticercosis. All proglottid specimens and stool samples were confirmed to be Taenia saginata by multiplex PCR and by copro-PCR and LAMP, respectively. Cysts collected from cattle were morphologically confirmed to be metacestodes of Taenia species. T. saginata taeniasis was identified from almost all ages from a 2-year-old boy up to a 88-year-old woman and most prominently in 15-29 age group (37%, 74/198) followed by 30-44 age group (34.8%, 69/198 ) from 15 of Mongolia's 21 provinces, while cattle cysticerci were found from 12 provinces. The highest proportion of taeniasis patients was in Ulaanbaatar, the capital of Mongolia.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Cattle/parasitology ; Child ; Child, Preschool ; Cysticercosis/*epidemiology/parasitology ; DNA, Helminth/*genetics ; DNA, Mitochondrial/*genetics ; Feces/parasitology ; Female ; Geography ; Humans ; Male ; Meat/parasitology ; Middle Aged ; Mitochondria/genetics ; Mongolia/epidemiology ; Neglected Diseases/epidemiology ; Nucleic Acid Amplification Techniques/veterinary ; Questionnaires ; Taenia saginata/*genetics ; Taenia solium/genetics ; Taeniasis/*epidemiology/parasitology ; Young Adult

Babesiosis is an emerging tick-borne disease in humans worldwide; however, little is known about the frequency of infection or prevalence of this disease in other parts of the world, excluding North America. In this study, we aimed to investigate Babesia microti infection frequency in a human population in Mongolia. One hundred blood samples were collected from stock farmers living in Khutul city of Selenge province, Mongolia. The sera and DNA from blood samples were evaluated for the presence of B. microti infection by using indirect fluorescent antibody (IFA) tests and PCR. The positive detection rates obtained using the IFA tests and PCR assays were 7% and 3%, respectively. This study is the first to detect of B. microti infections based on antibody seroprevalence or PCR assays for the presence of B. microti DNA in a Mongolian population.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; *Animal Husbandry ; Antibodies, Protozoan/*blood ; Babesia microti/genetics/*isolation & purification ; Babesiosis/diagnosis/*epidemiology/immunology/pathology ; Child ; Child, Preschool ; DNA, Protozoan/*blood ; Female ; Fluorescent Antibody Technique, Direct ; Humans ; Male ; Middle Aged ; Mongolia/epidemiology ; Polymerase Chain Reaction ; Seroepidemiologic Studies ; Young Adult