Background: Selenium (Se) is a trace element important for health. Its defciency has adverse effects on reproduction, immunocompetence and cardiovascular status. There is growing evidence that higher Se intakes are associated with reduced cancer risk. To date, there have been no studies conducted on the Se status of Mongolian children. Materials and Methods Non-fasting morning blood samples were collected from 240 children (122 male and 118 female) 6-36 months of age from the capital city of Mongolia and four provinces located in the south, north, east and west of the country. Inclusion criteria were apparently healthy children with no evidence of infection within the previous 7 days. The serum concentrations of Se were determined using graphite furnace atomic absorption spectrometry. Results: The mean serum Se concentration was 0.79 µmol/L. The indicator was higher for children in the rural provinces compared to those who lived in the capital city (0.81 µmol/L vs. 0.76 µmol/L, p=0.029). There was no statistically signifcant difference in the levels of Se detected between boys and girls (0.79 µmol/Lvs. 0.78 µmol/L, p=0.551). The serum concentration of Se increased with age (0.73µmol/L in the 6-11.9 months age group, 0.79 µmol/L in children aged 12-23.9 months and 0.82 µmol/L in 24-36-month-old participants). The prevalence of low serum Se in the surveyed population (<0.82 μmol/L) was 55.8%. The Se defciency tends to decrease with age (63.8% in the 6-11.9 months age group, 57.6% in participants 12-23.9 months of age and 48.2% in the oldest group). The prevalence of Se defciency is lower among children living in the western regions (38.3%) than among those from other areas of the country (60.4%). Conclusion: The high prevalence of Se defciency among Mongolian children shows that a wider survey that looks at the relationship between the blood Se and its concentrations in food and soil is needed.

Background: The prevalence of rickets is high among Mongolian children. The disease can be prevented by sufficient intake of vitamin D. Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, and is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Serum concentration of 25(OH)D is the best indicator of vitamin D status. The aim of this study was to determine the concentrations of 25(OH)D in serum samples of small children and evaluate their vitamin D status. Materials and Methods: The concentrations of 25(OH)D were determined in serum samples of 98 children (54 male and 44 female) 6-36 months of age using a 2-step radioimmuno assay procedure. Vitamin D defciency was defned as 25(OH)D < 25nmol/L. Results: The mean serum 25(OH)D concentration was 29.00 nmol/L with no statistically signifcant differences between boys and girls, age groups and children from rural and urban areas. The vitamin D defciency among the surveyed children was 61.2%. The defciency was higher among children from Ulaanbaatar city (65.7% vs 51.9% in rural areas) and in boys (66.7% vs 55.8% in girls). Conclusion: The high level of vitamin D deficiency indicates that there is a need to promote the expansion of the coverage of vitamin D supplements among young children.

Palliative medicine deserved to improve quality of life of patients with advanced, incurable diseases. During last 13 years palliative care workers tried to palliate the pain, physical, psychological, spiritual symptoms of suffering, but they never measured the quality of life of palliative care patients. The term quality of life is used to evaluate the general well-being of individuals and societies. 111 countries of the World established Country QOL Index. Quality of life should not be confused with the concept of standard of living, which is based primarily on income, should not be confused with quality of health services, which is based on medical supplies, equipment, quality of medicine, education level of health workers. Health related quality of life (HRQOL) is “The degree to which a person enjoys the important possibilities of his or her life”. Health related quality of life index not established for all medical specialties. Some tools for measuring quality of life established for diabetic patients (DQOL), cancer patients (Ca QOL), HIV patients (HIVQOL), and palliative care patients (Pa QOL). In Mongolia since 2000 started to talk about quality of services and in 2008 started program on quality of health services, but never provided study of health related quality of life of any patientTo provide the study of quality of life index within palliative care patients and compare quality of life index with pain score and score of other physical, psychological, spiritual suffering of palliative care patientsWe provided study of quality of life index within 60 palliative care patients by MISSOULA-VITAS®- 15 quality of life index, pain score by Wong Baker scale, symptoms of suffering by Anderson method, functional activities by Karnofsky performance scale, psychological problems by hospital anxiety scale23.3% of patients were up to 45 years old, 76.6 % were older 45. 70% of palliative care patients in our study were patients with cancer, 30% were palliative care patients with non cancer pathology. The mean Quality of life Index of total palliative care patients was 37.7. They had more common symptoms of suffering, like pain (90%), fatigue (83.3%), weight loss (83.3%), poor appetite (66.6%), thirst (66.6%), nausea (53.3%), constipation (60%)., depression (66.7%) and anxiety (70%). 56.6% of palliative care patients had spiritual suffering because of false hope, lost of meaning, relationship problems, and forgiveness. Increasing the score of symptoms of physical, psychological, spiritual and social suffering correlated to decreasing the quality of life index.We need to develop comprehensive palliative care to improve quality of life palliative care patients.

To study the correlation within psychological and social suffering in palliative care cancer patientsWe provide study within 100 palliative care patients with cancer stage 3-4. Depression was evaluated by San Diego hospice screening method with 3 questions. Anxiety was assessed by Spielberg -Hanin anxiety scale. Spiritual pain was assessed by San Diego hospice questionnaire, which includes main 4 factors of spiritual suffering, like cooperation, meaning of life, hope, forgiveness. Results of study was statistically evaluated by SPSS20 program.19% of patients had depression, 40% had anxiety, 46% patients had insomnia. 18% of patients with depression had spiritual suffering. 33% of patients with anxiety had spiritual pain. 31% of patients with insomnia had spiritual pain. Depression and spiritual suffering had mild correlation (R-0.318), anxiety and spiritual suffering had mild correlation (R-0.330), insomnia and spiritual suffering had very strong correlation (R-0.84). Psychological suffering of palliative care cancer patients increased with spiritual suffering and correlated with spiritual suffering. Especially insomnia had very strong correlation with spiritual suffering (R-0.84).