BackgroundTobacco use is responsible for a considerable number of morbidity and mortality in the World. It isconsidered to be one of the main preventable risk factors of non-communicable diseases. The tobaccosmoke contains more than 4000 substances that are harmful to health, and at least 43 of them arecarcinogenic. Globally, there are 1.3 billion smokers and nearly 5 million persons die every year fromtobacco-related illness. Based on current smoking trends, tobacco will soon become the leading causeof death worldwide. Most people begin using tobacco before the age of 18 years. Recent trends nowindicate earlier age of initiation and increasing prevalence of smoking among children and adolescents.In recent years the number of teenagers and women who smoke has grown significantly, with an averageage of initiation of 16 years.MethodsSurvey uses a global standardized methodology that includes a two-stage sample design with schoolsselected proportional to enrollment size. The classrooms within selected schools are chosen randomlyand all students in selected classes are invited to participate in the survey. The survey uses a standardglobal core questionnaire with a set of optional questions that permits adaptation to meet the needsof the country on tobacco use and key tobacco control indicators. A total of 7,298 eligible students ingrades 7-10 completed the survey, of which 6,178 were aged 13-15 years. The overall response rate ofall students surveyed was 92.3%.ResultsA total of 7298 students were covered in the survey. Amongst surveyed schoolchildren, 77.5% werestudents in grades 8-9 and 53.3% were females. 14.3% [95%CI: 4.7-6.7] of surveyed students (n=5775)currently used any tobacco product. Male students were as twice as more likely than female studentsto smoke daily [20.3%, 95%CI: 17.6-23.4 vs. 8.3%, 95%CI: 6.9-10.1]. 15.6% of students were havingever smoked cigarettes. Among those who have ever smoked, 8.6 percent reported to have first triedcigarette smoking before the age of 10-11 years. Male students were more likely to have earlier triedsmoking than female students (р>0.001). The percentage of students who currently use any tobaccoproduct is increased with the student’s age and it was the highest among students aged 15 years oldat 17.8% [95%CI: 15.2-20.8]. 28.6% of all surveyed students, 28.8% of male students and 31.8% offemale students smoked less than one cigarette per day. 37.4% of students smoked one cigarette perday, 25.5% smoked 2-5 cigarettes per day, 3.5% 6-10 cigarettes per day, 1.0% 11-20 cigarettes perday, and 3.9% smoked 20 or more cigarettes per day. 88.6% of those who tried to stop smoking did itbecause they wanted to be healthy. Of the current smokers, 84.3% think that they can stop smoking ifthey wanted to and most of the current smokers never received help or advice when trying to quit stopsmoking.Conclusion:The survey findings would serve as a baseline information database for undertaking a comparativeanalysis of tobacco smoking across the regions of the country; for evaluating of interventions and activitiesfor prevention and control of smoking related diseases; for establishing of surveillance system anddatabase on tobacco smoking; and for implementing of evidence based public health interventions anddecision making. Students had tried to stop smoking and wanted to quit smoking, however, programs,organizations and professionals who can help them to quit smoking are in shortage.

Brainstem Evoked Response Audiometry test is a method to diagnose and differentiate the type, degree and the location of cochlear and retroocochlear hearing loss for infants early. Test methods to determine cochlear and retroocochlear hearing loss was introduced relatively late in the clinical practice of our country. Even though, we started to conduct BERA tests since 2007, there hasn’t beenany research conducted for determining the normal results for children aged 0-5. Aim: The study aims to determine some average Results of BERA tests for Mongolian children aged 0-5 with normal hearing by age groups using Octavus-BERA apparatus.The research has been conducted using cross sectional method of analytic research from 2009-2013.For the study, 110 children from children aged 0-5 who were diagnosed to have normal hearing from audiological department of Otorhinolaryngological hospital and 16 children with sensorineural (cochlear) hearing loss have been selected randomly. When the latency of waves for children aged 0-5 with normal hearing were measured and the average results for 70 dB were obtained in the BERA test: wave I was identified to be 1.64±0.15 – 2.08±0.5msec. Wave III was 3.68±0.18 - 4.47±0.73 msec, Wave V was 5.37±0.23 - 6.76±0.65 sec. When the latency between waves were measured and the average results were obtained in the BERA test: Between waves I-III, it was 2.05±0.20 – 2.39±0.53 msec. Between waves III-V was 1.69±0.10 -2.34±0.70 msec and between waves I-V was 3.70±0.29 - 4.65±0.56 msec. The latency of wave I for children with sensorineural hearing loss was 2.32±0.76 msec, 4.62±0.59msec for wave III and 6.55±0.65 msec for wave V, which was elongated with a statistical probability (p=0.00-0.05). Latency between waves was 2.39±0.45 msec between wave I-III, 1.83±0.16 msec between waves III-V and 3.97±0.88 msec between waves I-V, which doesn’t have statistically significant difference from the normal results.As the children’s age increases, the latency of the waves will shorten and becomes relatively stable from 25-30 months which is similar to adults. While the latency between waves I-III had no difference with statistical probability for children with all ages, latencies for waves III-V and I-V shortens as children’s age increases.Latency for children with sensorineural hearing loss was elongated with statistical probability (p<0,005) from normal results. But in terms of latency between waves, there has been no statistically significant difference (p>0.05). This Result has critical importance in diagnosing cochlear deafness.

Introduction:According to studies range by the World Health Organization in 2010, 278 million people are deaf or hearing impairment, out of which 24% use an hearing aid and one out of every 10 people has been treated with surgical method and 9 people’s hearing loss has been restored using acoustic treatment method.Purpose:Our purpose is to define noisy vowels of Mongolian word, which will be used for configuration of hearing aid, thereby improve hearing ability.The objectives1. Analyze spectrogram for noisy sound of Mongolian word and define frequency and level of noisy words.2. Define average difference of listening level of the noisy sounds of Mongolian language using “Listening field of Mongolian word”Materials and method:We did the spectrogram for noisy sounds of the Mongolian word using voices of 62 people including male and female children as well as adults. Also, we analyzed frequency energy of all vowels noted in the 60-65 dB computer, via the “PRAAT” software, which defines analysis of speech in phonetics and studied listening level of the strong vowels using listening sphere of word.Result:During our studies, we selected the vowels [a], [e], [u], [o] [a], [ʊ], [ɔ], [i] and defined spectrogram and energy concentration (formant) of each vowel to define the vowels with the highest energy, and further found out that distance difference of the spectrogram of each vowel and frequency between vowels as 300-780 Hz. On the other hand, difference between spectrogram of each strong sound such as [sh], [s], [v], [z], [dj], [kh] has been defines as 340-2800 dB.When we observed the words with strong sound in the listening field of Mongolian words, which were 3- 5 dB lower than the clearer words.Conclusion:1. According to spectrogram, noisy sound [sh], [s], [z], [dj] has frequency of 3300Hz-3500Hz, which is noisier and resulted in poor acoustic listening ability. Further, we found out that Distant difference of vowels of Mongolian language [a], [e], [o] and consonants [m], [n] is far, accordingly, acoustic listening ability has been good, on the other hand, distant difference of vowels of Mongolian word [ʊ], [ɔ], [u] is near or close, accordingly, acoustic listening ability has been not well.2. Level of distinquishment of the noisy sounds of Mongolian word has been lower by 3.6+ 0.8Db to 5.2+1.2Db at levels of clear sound to feedback.

Thyroid nodular lesions are the common clinical problem in the world. A variety of tests have been employed to separate benign from malignant thyroid nodules. These tests include isotope scanning and fine needle aspiration cytology (FNAC). Our research was based on the fact that the comparison of FNAC and thyroid isotope scan in thyroid nodule was not researched in Mongolia. Therefore, we want to evaluate the specimen adequacy of FNAC, and compare its result to thyroid isotope scanning in patients with thyroid nodule. The research was conducted on archive materials of FNAC and thyroid isotope scanning of patients with thyroid nodule who were treated in surgical department of The First Central Hospital from 2012 to 2015, and the statistic analyze was done by using SPSS 20 under the auspices of School of Pharmacy and Bio-Medicine,Department of pathology, Mongolian National University of Medical Sciences. We have collected the FNAC of 807 patients, including 34 patients (4.2%) were males and 773 patients (95.8%) were females. FNA cytology results were interpreted as benign in 495 cases (61.3%), follicular lesion of undetermined significance in 31 cases (3.8%), follicular neoplasm in 9 cases (1.1%) suspicious in 17 cases (2.1%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). We have got the result of thyroid isotope scanning of 43 (5.32%) patients out of 807 cases. On thyroid scan, 18 patients (41.9%) having cold nodule were labeled as suspicious for malignancy, 25 patients (58.1%) had hot nodule. The FNA diagnosis of 25 patients with a hot nodule following: 1 patient (4%) with neoplasm, 17 patients (68%) with benign results, 6 patients (24%) had non-diagnostic. The FNA diagnosis of 18 patients (41.9%) with cold nodule following: 1 patient (5.5%) with follicular lesion of undetermined significance, 10 patient (55.5%) with benign, 5 patient (27.7%) with non-diagnostic, 2 patient (11.1%) had malignant. The FNAC results were interpreted as benign in 495 cases (61.3%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). Two patients out of 18 patients with cold nodule diagnosed as malignancy by FNAC. The sensitivity and specificity of thyroid isotope scanning was 96% and 16.6%, respectively.

Introduction Worldwide, numerous studies have been conducted and many papers have been published about the impact of climate change on human health, and the correlations between air temperature, precipitation, droughts, and floods, and their adverse health effects such as respiratory and water-borne diseases. Scientific evidence on this issue continues to mount, showing that the effects of climate change are mostly adverse to human health. In Mongolia however, scientific research on the effects of climate change on health is at its starting point and only a few studies have been conducted. Goal Determine and assess risk factors and effects of climate change on human health Materials and Methods The study area included Zavkhan, Selenge, Dornod, Umnugovi aimags (provinces) and Ulaanbaatar city, each representing one of the five climatic zones of Mongolia. Daily meteorological variables for temperature, atmospheric pressure, wind speed, highest wind speed, precipitation and relative humidity of the selected study sites from 2009 to 2011 were acquired from the Institute of Meteorology, Hydrology and Environmental Monitoring. Statistical analysis of the collected data was done using the SPSS18 program and 95%CI was used to determine inter-zonal differences of weather and climatic variables. Results In order to determine climate risk factors, the analysis used the number of days when temperature exceeded mean annual air temperature by +25°С/-25°С, and their sequences, the number of days when the absolute temperature exceeded +30°С in summer months, and -30°С in winter months, and their sequences, the number of days when daily fluctuations in atmospheric pressure exceeded 30 hPa and the number of days when relative humidity was lower than 30 percent or greater than 80 percent, and their percentage of the total number of days.

Ectopic pregnancy (EP) is a life – threatening emergency, and a significant cause of maternal morbidity and mortality in Ulan – Bator. The aim of this research was to determine and evaluate the incidence, risk factors and treatment of ectopic pregnancies at The First Maternity Hospital in Ulan – Bator.This was a retrospective, descriptive study of EP’s managed in The First Maternity Hospital during the study period 2013, 2014.The medical records of the patients managed for ectopic pregnancy as well as the total birth record and gynecological admission records during the period under review were retrieved, and data were collected with the aid of data-entry forms designed for this purpose. There were 46.147 gynecological admissions and 28.744 deliveries, with 870 cases of ectopic pregnancies. A total 863 cases were suitable for analysis. The relevant collected data were analyzed with SPSS Version 20.0 for windows.Ectopic pregnancies constituted in 3.9% of all gynecological admissions.Majority of patients were in 25-29years age group (64.1%). The average age of patients was 30 +/- 6 years. In 83.8% of patients had previous abortions, inflammatory disease was the most frequent risk factors.521(60.3%) patients were treated surgically while the 342(39.6%) remain patients received conservative treatment.The incidence of ectopic pregnancy increased by 0.8%, which is comparable between 2013(2.5%), 2014(3.3%). In our study the number percentage of organ preserving treatment, such as tubostomy and conservative – treatment by methotrexate increased significantly.

BACKGROUND:Nano is a key technology to bring accelerated development in science, economy and business in 21stcentury. Besides lots of advantages contained in nanoproducts, cytotoxic effects on human and environmentmay occur due to their extreme small size and large surface area and it promotes chemical reaction andactivates reactive oxygen species in the cell. In the last few decades, human and environment exposureof nanomaterials have been increasing, but research papers related to nanomaterial toxicity have beenpoor.GOAL: Determination of nanomaterial toxicity in medical applicationMATERIALS AND METHODS:Totally 21 nanomaterials collected in this study including imported nano-medicines, disinfectantspray, cleaning solution and experimental nanomaterial produced in Mongolia. The particle sizesof nanomaterialswere determined by Cross correlation analysis and X-Ray diffraction analysis, andmutagenicity was determined by Ames test.RESULTS:The particle sizes of nanomaterials in 5 of 21 were measured at the range of 1 – 100nm and 5 of 21nanomaterials were determined as mutagenic by Ames test.CONCLUSION:Ingredients and production methods can be one of causes of nanomaterial toxicity. Therefore, morespecific methods are needed to reveal cytotoxicity of nanomaterials in the future.

BackgroundIn 1988, the Forty-first World Health Assembly adopted a resolution for the Global Polio Eradication.Since the initiative was launched, number of polio cases has fallen by over 99%. Today, only threecountries in the world, Afghanistan, Pakistan and Nigeria - remain polio-endemic. The Polio Eradicationand Endgame Strategic Plan of 2013-2018 calls for the gradual eradication of wild virus strain and thevaccine virus strain at the same time. In order to prevent the border transmission of wild type poliovirus,virus leakage from laboratories, it is required to conduct inventory of laboratories handling poliovirus andpotential infectious materials every 2 year.GoalTo identify laboratories handling poliovirus and potential infectious materialsMethodsSurvey of laboratories handling poliovirus and potential infectious materials was conducted amongstate, private, clinical, biomedical and environmental testing in total of 127 laboratories operating in21 provinces and 9 districts of Ulaanbaatar city by questionnaire. Survey questionnaire consists of 6sections (general, sample storage, laboratory biosafety, staff knowledge, information source, trainingand etc.). Study results were processed using SPSS-19 statistical programme.Results34.7% of 96 biomedical laboratories were analyzed stool samples. These laboratories were analyzedrotavirus (17.0%), intestinal bacteria (67.0%), Helicobacter (14.3%), parasite and other indicators (1.7%)in stool samples. 43.8% of laboratories were stored stool samples for one day and 3.1% up to oneyear. From 31 environmental testing laboratories 73.3% were bacterialdetection test on environmentalsamples. 60% of wastewater samples were collected from rivers, 16% on entrance to wastewatertreatment plant and after biological treatment combined, and 24% from other sources. Soil sampleswere collected near waste disposal and other sources (46.4%), and from unknown sources (53.6%).24.1% of all laboratories were stored environmental samples for 3 days, 3.4% for 45 days. Accordingto results, surveyed laboratories did not store samples for more than 1 year. Also, none of surveyedlaboratories (100%) were not stored poliovirus and potential infectious materials.Conclusion· The investigated laboratories were not stored poliovirus and potential infectious materials.· The biosafety and biosecurity status of laboratories should be improved in near future throughenhancing knowledge of laboratory workers and organizing training related to biosafetyandbiosecurity.

BackgroundClimate change, as defined by the United Nations Convention on Climate Change, is a “Change of climate which is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and is observed over time”. In 2001 an Initial Communication on Climate Change was prepared by the Government as part of its obligations under the UNFCCC. One of its recommendations was for “creating public awareness among a wide range of stakeholders including public, private and community sector organizations”. GoalThe main goal of the study was to develop recommendations and measures on prevention from diseases and adaptation to climate change by assessing knowledge, attitude and practice (KAP) of population towards climate change. Based on the main goal the following objectives were setup. Therefore addressing the different levels of knowledge and types of attitudes and practices people have towards climate change must initially be dealt with at the local level where site specific variations can be accounted for. Once research has been undertaken at the local level it can later inform decisions and policy at the regional, continental and global levels on how to incorporate site specific variations with in the greater context of the global threat.Objectives:1. To determine knowledge and attitude of population towards climate change;2. To determine practice of population on some adverse consequences of climate change;3. To develop recommendations and measures on prevention from and adaptation to climate change;Materials and MethodsThe study was at once carried out by means of questionnaire. In order to assess KAP of population, the data was collected using a card with 38 questions in three chapters which previously produced and ratified. The questionnaire was structured into 4 sections; demographics, knowledge, attitudes and practices. Two sums in an aimag from each climate zone of Mongolia were selected. In total, 2258 respondents aged 15 to 64 were involved from eight sums in four aimags (Zavkhan, Selenge, Dornod and Umnugovi), and two districts in Ulaanbaatar. The study data was input to computer using EPIDATA-3.6 software and statistically analyzed using SPSS-18.0 software.ResultsA total of 2258 individuals were interviewed. 44.1% 44.1% (995) of the participants was residents of Ulaanbaatar city and remained percentages accounted for residents living in the center of aimags and soums. 56.7% (1281) of participants were women and 43.3% (977) were men aged with 35.2±15.1 in average. Most of the study participants had educated with medium level (34.8%) and high level (30.0%). Employment percentage is 47.5% (1073). However, most respondents interpreted the meaning of climate change as “a change in weather,” “a change in normal climate conditions,” or “a change in temperature” – answers that requires more common sense than climate change savvy. Global warming is one of the evident of climate change. To know study participants awareness about climate change we used terminology of global warming. 25.3% (571) of the total participants answered that climate change revealed by the overheating or warming earth surface. 42.4% of the respondents answered the climate change could affect to health, 33.2% to environment and 16.3% to economy. 84.5% (1908) of the study participants agreed with that climate change has been started. Most of them (71.3%, 1824) allowed that people’s improper use of nature tend to global warming. When ranging the protection practices during the strong storm means of timbering the houses or gers accounted for 42.5% (960). Study participants supported the following activities; 41.2% (931) agreed that is it necessary to increase health services and 34.1% (769) suggested that it is better to enhance training and propagation for increasing awareness of population about climate change adaptation procedures and some information on climate changes and protection events. 85.2% (1923) of the study participants answered that they want to get the information on climate change from public TV.ConclusionsAlthough knowledge on global warming as the climate change was poor among the respondents, they agreed the climate change has already been started worldwide as well as in Mongolia. Only half of the respondents have had practice to prevent themselves from natural disaster.

Among world population, 23.4% have different kinds of hearing disorders and 56% are middle ear disorders, 30% are inner ear disorder, 10% are congenital deaf and 4% are congenital mixed outer and middle ear disorder (WHO info, 2006).In 1995, by the German research, 2% of newborn babies were deaf therefore, among children from 1-18, 16% had middle ear disorder and 0.8% had inner ear disorder. In most cases (54%) cause of hear loss and deaf as sound transmitting apparatus. Later in 2010, sound transmitting apparatus related disorder was decreased by 22.4% J.Helms1995 , K.Schwager 2010 . Doctors proved that 62% of sound transmitting apparatus related disorders are middle ear diseases, 16,2% out of the diseases have the defect of malleus, 44,1 % have the defect of incus and discontinuity of incus and stapedius, and 39,7% is totally absent of ossicular chain 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Aim: To recover sound transmitting related hear loss with titan prosthesis implant. 120 tympanoplasty III type surgeries were operated in 2011-2013 in Mongolia. Clinical and operative features of the tympanoplasty III type surgeries were prospectively recorded. Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middle ear and 16 cases (13.3%) were adhesive otitis media. The air and bone gap of all patients were above 15-35 dB. HEINZKURZ firm’s TTP-Variac system’s titan prosthesis was used. Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size of titan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm waschosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation Out of the surgeries, 51 cases (42.5%) were cholesteatoma, 53 cases (44.2%) were granuloma middleear and 16 cases (13.3%) were adhesive otitis media.Titan prosthesis PORP was carried out in 86 cases (71.6%). For 40 (45.5%) out of the 86 cases, size oftitan prosthesis PORP 2.25 mm was chosen. Hearing level increased for 72% out of patients by 10-25 dB after the operation. However, for 46 (54.5%) out of the 86 cases, size of titan prosthesis PORP 2.5 mm was chosen. Hearing level increased for 82% out of patients by 10-30 dB after the operation. Titan prosthesis TORP size 4-4.25 mm was chosen for 34 (28.4%) out of 120 cases. Hearing level increased by 10-30 dB for 80% out of patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. We drum cover the cartilage and cartilage film is used to by Canal wall down, Canal wall updone. Hearing level decrease d by patients involved after the operation. Implantation of Titanium prosthesis increased hearing capability by 80% dB. The air transfer of more than35 dB air-bonegapofmorethan15dB we observed defect of hearing bone