WHO informed that across world an average of 565 young eople aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological onsequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study nxiety among abused adolescents, some physical parameters and level of cortisol in saliva.Total number of participants were 149 children aged between 11-16 years (number cases were 53, matched control subjects were 96). The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report uestionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, USA. Average age of all subjects in the study was 13.52±1.57 and 102 of all subjects were female and 47 were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (21.3±8.1 ng/ml) statistically significantly lower (p<0.01) than average amount of control group (31.56±16.9 ng/ml). Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.

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.

IntroductionAccording to the World Health Organization (WHO), non-communicable diseases (NCDs) such as cardiovascular diseases (CVDs), diabetes, chronic pulmonary diseases and cancers accounted for 60 percent of mortality in the global population and 80 percent of mortality in low and middle income countries in 2008.Mongolia has been undergoing an epidemiological transition since 1990s. As a result, diseases related to lifestyles and health behavior, such as cardiovascular diseases, diabetes, cancer and injuries are growing steadily and have become the leading causes of population mortality.PurposeTo determine the prevalence of common risk factors for non-communicable diseases among civil servants in Bulgan aimag.Materials and MethodsA total of 300 randomly selected 22-64 years-olds of staff from 9 organizations of Bulgan aimag participated in the study. The prevalence and measures of average distribution of NCD risk factors were estimated.ResultsOut of all participants, 135 were males and 165 were females. Most respondents (96.3%) knew that smoking harms their health. With respect to the frequency of smoking, 15.5 % (95% CI 11.4-19.7) of the respondents were regular smokers, 10.5% (95% CI 6.9-13.9) were irregular smokers and 65.5% (95% CI 60.1-70.9) were non-smokers. 47.1% of the population strongly agreed to the statement that the Mongolians tend to drink too much alcohol at one time and another 47.8% agreed with this judgment. The attitude of the community related to the daily consumption of fruit demonstrated that only 28.2% (95%CI 23.1-33.3) of the respondents considered having fruits daily as “very important” and 58.7%(95%CI 53.1-64.3) considered it as “important”. According to the study results, the prevalence of people engaged in moderate levels of physical activity was 48.5% with significantly more males (60.9%) (95%CI 52.5-69.3) engaged in such activities than females (38.4%) (95%CI 30.9-45.9).Conclusions:1. The samples examined by this study demonstrated a good knowledge on the harms of smoking (96.3%) and second hand smoking (99%).2. The majority of the respondents (94.9%) agreed that the Mongolians tend to drink large amounts of alcohol at once.3. In general, many Bulgan civilians are lack a health promotion attitude in regards of daily consumption of fruits and vegetables, with only about 28.2% of the respondents considering it as very important.

Background: High blood pressure is both a cause and a complication of chronic kidney disease. As complication, high blood pressure may develop early during course of chronic kidney disease and is associated with adverse outcomes, in particular faster loss of kidney function and development of cardiovascular disease. The purpose of this study is early detection of chronic kidney disease in patients with hypertension by defining the prevalence of microalbuminuria.Methods: The study population consisted of 169 subjects with a hypertension. Individuals were considered to have hypertension if the blood pressure measured greater than 140/90 mmHg or if they were taking blood pressure lowering medications. Microalbuminuria was defined as 20 mg/l or greater. Results: We are presenting data on 169 subjects :male 38 (22.5%) female 131 (77.5%), average age 51.6±0.89 At screening, 14.8% of all participants were smokers, 62.1 % engaged in low levels of physical activity, 72.8% - were having tea with salt (table1). Microalbuminuria and renal failure, as GFR<60 ml/ min/1.73 m2, were documented in 34.3% and 16.6% of subjects, respectively. There is positive correlation between MAU and increasing-range of blood pressure (table2). Correlation was found between albuminuria and GFR(r= -0.2 p<0.01) and serum creatinine(r=0.31 p<0.01) the regression result has shown that GFR is associated with MAU and serum creatinine (table 3).Conclusions:1. In 34.3% of patient with hypertension was found nephropathies with MAU2. Microalbuminuria is increased with decline of GFR and raise of systolic blood pressure. GFR decline is with the raise of age and serum. It is important to implement in clinical practice screening of MAU hypertensive patients.3. In 2/3 of all screened subjects was found 1 and more risk factors for CVD.

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.

Background: Natural protection against Mycobacterium tuberculosis is based on cell-mediated immunity, which most importantly involves CD4+ and CD8+ T-cell subsets. Therefore, the evaluation of CD4+ and CD8+ T-cell profi les are important to evaluate cell-mediated immunity. Immuno-regulating therapy is important in increase of T cell subsets. Objective: To determine some T-cell subsets in active pulmonary tuberculosis patients following immunoregulating treatment in intensive phase of antituberculosis treatment, so to evaluate the treatment effect. Method: This study was conducted in TB clinic of National Center for Communicable Diseases (NCCD) between Aug 2008 and Mar 2009. CD4+ and CD8+-T cells were evaluated in 50 active pulmonary tuberculosis (infi ltrative form) cases before antituberculosis treatment (25 cases with Salimon-Study group, 25 cases without SalimonControl group) Patients with chronic disease, pregnant and alcohol users are excluded. The T cell subsets count was performed by FACSCount fl ow cytometer at the Immunology Laboratory of the NCCD,Mongolia.The monoclonal antibodies to CD3, CD4 and CD8 (Becton Dickinson) were used for the analysis. Result: CD4 count was 605,1242,7 cells/microL, CD8 count-470,92235,7 cells/microL, CD3 count-1130,7425,6 cells/microL, CD4/CD8 ratio was-1,480,67. CD4, CD8, CD3 cells were signifi cantly lower (P=0.05) in active pulmonary TB patients than in healthy Mongolian. And these subsets were signifi cantly lower in older patients (>50 age).There was no statistical signifi cance in sex and other age groups (p>0, 05). There were statistical signifi cances such as CD4 count, CD4/CD8 ratio (CD4-733,95314,38 cells/micro, CD4/CD8 ratio-1.870,7 in treatment group, CD4-570,54213.07 cells/micro, CD4/CD8 ratio-1.260.45 in control group) between TB and control group at the end of intensive phase of antituberculosis treatment (=0,05, =0,001). However, there were not any signifi cance CD8 count and CD3 count between two groups (CD8-423,68174,28 cells/microL, CD3-1212,27453,98 cells/microL in treatment group, CD8-500,67203,74cells/microL, CD3 -1139,33 386,47 cells/ microL in control group) (=0,05). Conclusion: 1. T cell subsets were signifi cantly lower in active,new,smear positive, pulmonary TB patients than in healthy Mongolians (p=0.05). 2. The statistical signifi cance is observed in 50 years and older TB patients (p=0.05). 3. CD4, CD4/CD8 were signifi cantly higher in patients treated with immuno-regulating treatment than in patients of control group (=0,05, =0,001).

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.

Background: Lead is known for their neurotoxicity and compared to adults, children are more vulnerable to lead exposure. Varieties of diseases are developed by lead induced damage in children, including decreased intelligent quotient and behavioral changes, such as anxiety. In normal condition lead does not exist in children’s blood and this toxic heavy metal enters into human body through respiratory way and accumulates in blood and bone to harm neurodegenerative and urinary systems. Therefore, the present study aimed to investigate whether the emitted lead from recycling factory for lead acid batteries, which is located in 9 km distance from Khonkhor town and 39 km faraway from Ulaanbaatar city with north-east direction, is affecting the intelligence of the local children. Methods: There are 13 children involved in this study and the participants are divided into two groups, including subjects, who live in areas outside (n=10) and within (n=3) the 1000 m region of the factory zone. The blood sampling was collected according to WHO guidelines and lead level in blood was determined by Leadcare instruments at Environmental health and toxicological laboratory of National Center for Public Health. The intelligence analysis was conducted by Raven’s progressive matrices test. And the statistical analysis was performed by SPSS 21 software to assess correlation of blood lead levels and the intelligence among participated children. Results: It is resulted that average lead level for children’s blood samples is 3.1±1.5 ug/dL and which is found beyond the acceptable range in WHO guidelines. The children’s intelligence was assessed by Raven’s colored Progressive Matrices analysis, which is practically accepted in China, which estimated that average intelligence score of participants were 48.3±13.2. According to correlation analysis of age, sex, intelligence and blood lead level, there was a weak positive correlation was found between children’s age and lead level in blood. In contrast, a weak reverse correlation was observed in regarding with sex and blood lead level and intelligence score was weakly reverse correlated with the lead level in children’s blood samples. Conclusions The determined average lead level was 3.1±1.5 ug/dL for blood samples collected from 13 children who involved in this study and the value is found under the WHO guidance value. Furthermore, their average intelligence score was estimated as 48.3±13.2. The comparative analysis shown that intelligence score of 3 children, who lives within 1000 m region of the recycling factory was lower than those who lives in outside region of the factory and have same age.