INTRODUCTION: Main reasons of metabolic syndrome are obesity and overweighing, which are becoming a global worldwide problem. Obesity is both a prevalent condition worldwide and a well-known, modifiable risk factor for various diseases, including diabetes. In a recent review article, waist circumference (WC) and body mass index (BMI) were reported as established risk factors for diabetes. GOAL: To define the prevalence of metabolic syndrome among Mongolian aging man living in Ulaanbaatar city MATERIALS AND METHODS: Randomly selected 180 men aged 35-90 years old were involved to this study. All were informed and written consent was given by each individual. The metabolic syndrome was defined by NCEP definition: high blood pressure, high waist circumference, higher fasting sugar, triglyceride and HDL-cholesterol. Anthropometric parameters like waist circumference (WC), weight, height, blood pressure and blood chemical parameters like glucose, triglyceride (TG), HDL-cholesterol (HDL-Ch) were measured by automatic biochemical analyzer. RESULT AND DISCUSSION: Average age of all participants was 56.82±12.55 years and was divided in three age groups: 35-60 (n=112), 61-74 (n=47), 74-90 (n=17). The characteristics of participants are shown Mongolian men in 38.8 % (70) of all participants had a metabolic syndrome and in compare to T.Baysgalan’s study, implemented in 2007 was higher. In our opinion it depends on our study participant’s age, because in our study number of elderly were predominating than mentioned survey. Waist circumference in metabolic syndrome group is higher than in healthy control group (p<0.05). Triglyceride level does not change with aging, but in our study participants, the TG level was negatively correlated with aging in metabolic syndrome group (r = -0.307). HDL-cholesterol is abundantly circulating molecule in human plasma and shows anti-atherogenic effect. In our participants HDL-Ch decreases with aging (r=-0.174). CONCLUSION: Our pilot study present that metabolic syndrome prevalence reaches 38.8% of total aged, male participants, and it is leads to implement and provide an investigation in large range, including urban and rural areas of the country.

According to the 2013 WHO survey, the world’s leading cause of death is a coronary heart disease which is accounted for 12.9%. Bypass surgery by grafting Artery mammaria interna to the left anterior descending coronary artery is more clinically significant and has long become an international standard. Aim: To study the outcomes in patients who undergone a bypass surgery ofgrafting the Artery mammaria interna to the left anterior descending coronary artery in an open heart surgery. In 2014 in the case-control study conducted at the Shastin 3rd National Central Hospital, 8 patients who undergone a bypass surgery of grafing Artery mammaria internasinistra to the left anterior descending coronary artery were selected for a case group and 8 patients with bypass grafting of a superficial vein of the leg to the coronary artery were selected as a control group. Related diseases, heart function, type of grafting performed, and post-operative complications were studied. The successful bypass surgeries of grafting the Artery mammaria interna sinistra to the left anterior descending coronary artery without complications in the case group in 2014 has demonstrated that the Mongolian cardiosurgical team was able to successfully and fully introduce this innovative approach that has become an international standard of coronary artery surgery. The introduction of this method enables to eliminate angina pectoris symptoms in patients, restore and improve heart contractions, reduce the chances of a repeat heart attack, and thus, to improve the patient’s ability to live and work normally.

Introduction: Pancreatic cancer in young patients is usually correlated with chronic alcohol consumption and hereditary factor. Chronic pancreatitis, pancreatic trauma, pancreatic cyst, alcoholism, and diabetes mellitus are the most clearly established etiological factors (T.Y Flanders., W.S Foulkes., 1996). The cancer was located to the pancreatic head in 75% to the body in 15-20% and to the tail in 5-10% of cases (A.E Richard., 2005). Goal: Determination of the US signs in pancreatic cancer and establishment standard (control) US diagnostic criteria. Objectives: 1. To reveal direct and indirect US signs of pancreatic cancer. 2. To establish standardized US diagnostic criteria. Materials and Methods: A prospective study was carried out in 35 patients with pancreatic cancer in a 4 years period between 2006-2010 (Shastin Central Hospital, Achtan Clinical Hospital). To each patient has being filled special investigation chart. Diagnosis was confirmed on the result of physical examination, laboratory investigation, abdominal conventional radiography, upper gastrointestinal contrast radiography, CT, MRI, ERCP and biopsy. The results of the measurements were compared with the standardized control evaluation of Mongolian people (Ts.Badamsed.B.Tserendash). Results: Our sample represents US signs in 35 patients with pancreatic cancer. On the basis of our study US sign were divided into two categories: direct and indirect signs. Direct signs: a) irregular shape, b) irregular tumour edge, c) hypodensity, d) tumour size more than 2.1cm, e) different location. Indirect signs: a) CBD distends, b) gallbladder distends, c) intra hepatic bile duct distend, d) pancreatic pseudo cyst, e) near-aortic limp node enlargement, f) splenomegaly. We consider that the upper mentioned US abnormality can be as control standard criteria for the US diagnosis of the pancreatic tumour. According to the study of V.N.Demidov and G.P.Sidorov (1987), the pancreatic cancer is located to head in 50-80%. In our series it was about 45.7%± 8.4. Irregular tumour shape in 60.0%±8.3, tumour hypodensity 80.0%±7.2, irregular tumour edge 68.6%±7.8, tumour clear definition 71.4%±7.6 which are the same with N.M. Mukharllyamov (1987). Conclusions: 1. Were described direct and indirect US diagnostic signs in pancreatic cancer 2. The tumor location, shape, size, edge, consistency, intra and extra hepatic bile duct distend, gallbladder distend, near-aortic limp node enlargement are the basic control criteria for the diagnosis of pancreatic cancer.

Background: In recent years, kidney complication of diabetes became the basic cause of the end stage of renal disease in many countries around the world and then primary kidney disease goes on the 2-3 places. Due to the fact that diabetes mellitus turns more and more into non-communicable worldwide epidemic, we faced the increase in kidney complication which is one of form of micro vascular complications. So, illness of every 1-2 in three patients to undergo a renal replacement therapy has been diagnosed as diabetic nephropathy and of course nephrologists could not leave this fact without their attention. Goal: To study a change in the kidney structure with type 2 diabetic patients. Materials and Methods: Within the scope of the research 35 autopsied passed way because of the type 2 diabetes in clinical hospitals. According to Tervaert classification of diabetic kidney pathology issued by American Society of Nephrology in 2006, changes in glomerular structure were divided into 4 classes. Ordinary staining methods as hemotoxilin eosin, Van Gizonestaning connective tissue, Periodic Acid- Schiff standing have been used.Results: 35 autopsied in total, including 23 male (65.7%) and 12 female (34.3%) were covered by this research. And glomerular basement membrane thickening discovered in 51.4%, mesangial matrix expansion in 34.2%, Kimmelstiel-Wilson nodule in 20% and advanced glomerulosclerosis in 8.5% of total cases, respectively.Conclusions:1. It is found that diabetic kidney can be classified by Tervaert classification using ordinary standing and PAS reaction on the light microscope.2. However, we faced an essential necessity to be armed with immunofluorescence and electron microscope for the purpose to improve diagnostic examination and establish classes more accurately.3. Today when the medical science develops as evidence-based medicine, a starting the kidney biopsy samples assaying become the vital issue in comparative studying the clinical stage of diabetic kidney pathology.

INTRODUCTION: Adipose tissue exclusively secretes adiponectin, a 244–amino-acid protein that regulates themetabolism of lipids and glucose and circulates quite abundantly in plasma. Adiponectin were still stronglyassociated with an increased diabetes risk in men; but the association for women was no longer statisticallysignificant. Adiponectin decreases insulin resistance and body weight by increasing lipid oxidation in muscleand other organs such as the pancreas and liver.GOAL: To define of adiponectin level in aging man living in Ulaanbaatar city.MATERIALS AND METHODS: Randomly selected 84 men aged 35-90 years old were involved to this study. Veinblood were collected, the serum were separated and were frozen until assayed by immunosorbent assay.Morning baseline adiponectin were determined in the sera. We used ELISA kit from Mesdia company (Korea).RESULT AND DISCUSSION: Average age of all participants was 56.82±12.55 years and was divided in three agegroups: 35-60 (31.1%), 61-74 (10%), 74-90 (5.55%). Levels of adiponectin were inversely associated with BMI(r=-0.103), WC (r=-0.173), and TG (r=0.143) and directly associated with age and HDL-C (r=0.117, p<0.001).All people were divided by NCEP criteria in two groups: metabolic syndrome group and healthy control group.Average adiponectin level in metabolic syndrome group was 4.83±7.10 ug/ml, in healthy group it was 5.71±7.53ug/ml, which shows that adiponectin level is significantly lower in people with metabolic syndrome.CONCLUSION: Adiponectin level was lower in people with metabolic syndrome and it has inverse correlation withwaist circumference.

The research on the smoking habits among 8th-to-12th grade students of schools was conducted using a random sampling method among the 13-18 years old school students.Materials and MethodsThe research was performed using a combination of both qualitative and quantitative methods. The quantitative part of the research was performed by conducting surveys among randomly selected secondary school students according to prepared and approved questionnaires. The qualitative study was performed by organizing focus groups based on prepared discussion guidelines. Sampling: the survey participants were students in grades 8-12 from both public and private schools in Ulaanbaatar, the capital city of Mongolia. A total of 1190 students from the 12 secondary schools of 6 districts were selected through random sampling.Resultsto the question of whether the participants have tried to smoke once or twice, 36,1% (407) responded positively. Among these respondents, 49.6% (272) are male and 23.2 (135) are female. This confirms the statistical data that male students are more exposed to the habit of smoking than female students (x2=57.8, p<0.01). The percentage of the currently smoking students is 11.2% (77) of whom 17.9% are male and 4.8% are female. Of the current smokers, 6.8% smoke every day (x2=48.3, p<0.01). The average age of taking up smoking was 14.0[±1.8] of which males students began using tobacco at 13.9[±1.8] years and females at 14.3[±1.6]. Among the smoking students, 10[±2.1]% were from public schools and 17.3[±2.8]% were from private schools (x2=8.1, p<0.01).

BACKGROUND. Head and neck cancers are related group of cancers that involve the oral cavity, pharynx (oropharynx, nasopharynx, hypopharynx), and larynx. Early-stage tumors of the upper aerodigestive tract can be cured; for late-stage disease, prognosis is poor. Nowadays microvascular free tissue transfer surgery performed at high level. Worldwide, this particular kind of operation in head and neck surgical field has become “golden standard” of treatment. Seemingly, plastic and reconstructive surgeons of developed countries widely perform forearm free flap, anteriolateral thigh free flap, fibula free flap, rectus abdominal free flap, latissimusdorsi free flap. We purpose to report our first 121 cases of Microvascular Free Tissue Transfer which had been performed at the head and neck surgical department, NCC of Mongolia. METHODS. The clinical records of first 121 cases patients who had microvascular reconstruction done between 2011 and 2017 were reviewed. The indications for surgery, choice of flap, duration of surgery and flap survival were noted. RESULTS. Our study were performed on 121 cases, among them 84.3% flaps were survived, most of defects occurred following cancer resection. Anterolateral thigh and radial forearm flaps were performed commonly for our reconstruction surgery. CONCLUSION. 84.3% free flap recorded success rate indicates our early experiences. Although the National Medical University do not have postgraduate reconstructive and plastic surgical training, we believe that meticulous planning, careful vessel selection, close flap monitoring as well as improved infrastructural support can lead us to much better success rates of microvascular reconstruction in our country.

The increasing proportions of aged persons have been accompanied in the world. NCDs are often associated with older age groups. High blood glucose levels and unhealthy diet increase the risk of or cause most NCDs. In this study we aimed to determine correlation between the older people (60<) blood glucose level and food consumption. 1563 healthy elder people participated in this research. We measured blood glucose level in all subjects at the Nursing school’s Training and Research Center of health science university of Mongolia. Ulaanbaatar city, Orkhon aimag, Khovd aimag, Khentii aimag, Bulgan aimag, Dornogovi aimag, Tov aimags represented urban areas, while the rest of aimags and soums represented rural areas. The questionnaire was used to collect data on respondent’s social-economic status, fruit and vegetable consumption, physical activity, and their causes. In order to assess the diet pattern of the surveyed population, the respondents were asked about frequency of fruit and vegetable consumption, type of oil used in food, and amount of salt consumed daily. Simple regression analysis was performed to shown that significantly positive correlations between blood glucose and salt intake (р<0.001), The other composition are no significantly changes.

Determine the pituitary thyroid gland axis function abnormalities and relate it with serum lipid level.We enrolled 313 elderly people from UB and Orkhon aimag. Serum total TSH, T3, T4 hormones, low –density lipoprotein, high-density lipoprotein, total cholesterol and triglyceride level were defined by ELISA and fully automatic analyzer. All analyses were conducted with the use of SPSS 19.0, MS Excel 2007 program in which mean variables, One way Anova test and bivariate correlations are included.A total of 313 elder subjects, male 29.4%, female 70.6% and mean age was 71.8±9.8. Pituitary thyroid hormone abnormalities were detected mostly in females (p=0.027), thyroid hormone decrease was noticed in 70-79 age. In all groups serum triglyceride level as in normal range but it was significantly high (p=0.027) in hypothyroid group. Triglyceride level was negatively correlated with total T4 (p<0.01), positively correlated with T3 (p<0.01).Thyroid hormone decrease increases serum lipid especially triglyceride level. Furthermore it increases atherosclerosis risk factor to elderly people thus affects the quality of life.

Risk management practice and decision making are paramount for doctors to improving patient outcomes and managing the total cost of risk in our evolving healthcare landscape. In Mongolia there are no legal regulations about health professional’s liability insurance. The aim of the study is to provide relative information about the legal environment, systems and financing of liability insurancefor health professionals in selected foreign countries and Mongolia and to look at what policies and regulations could be applied to Mongolia.We carried out a policy study focused on health professionals’ liability insurance in four selectedcountries. We investigated health professionals’ liability insurance situation in Mongolia in the year of 2012-2014 byReviewing and analyzing the data related to health professionals liability insurance voluntary from the top six insurance companies’ by size and interviewing managerial level staff at these companies Studying court decisions related to health professionals’ errors to see how many health professionals could be prevented from court hearing Studying patients’ complaints against health professionals as filed with the Ministry of Health andSports to see how much risks are facing by health professionals.There are two main legal systems we discovered regarding resolution of health professionals’accountability for patient complaints: Court sentencing. Examples include Mongolia and the United States. Reimbursing the loss. Examples include Switzerland, Finland, New Zealand, Canada, Australia, England, and the Russian Federation. There are two insurance types for health professional’s liability: А. Compulsory B. Voluntary1 In USA, Canada and England, the liability insurance system for health care providers developed late in 19th and earlier in 20th century. Today, both private and nonprofit insurance entities in these countries insure health professionals and members of the health professionals’ association. England has rich experience of health professional’s liability insurance and the system is too large. Data fromthe England legal system shows that one case may take up to 4 years to receive a final decision. In order to determine health professionals’ fault with regard to claims, a health professionals’ liability damage assessor is needed who is well experienced and trained in healthcare law. Mostly not more than 30 percent of the claims are reimbursed. In Canada, statistical trends show claims against health professionals continue to increase. As a result, doctors prescribe additional laboratory tests and other additional investigations which increase health sector costs. In Russia in 2010 the health professional’s liability insurance law is approved and the implementationwill start January 2017. In Mongolia in 2012-2014, there were registered 373 complaints and errors against health professionals and 162 clients applied court complaints. During this period, 27 health professionals received court sentences. Health professionals liability insurance premium is calculated 0.8-3.5 percent of the insurance valuation. In 2012-2014 total 4377 health professionals insured voluntarily against professional liability.In most developed countries health professionals are protected from sentence to court. Averagecomplaints against health professionals have continued to increase steadily similarly in other countries.Therefore health professional’s professional risk is increasing. It shows that it is very important to improve the legal environment of the liability insurance system for Mongolian health professionals. of coronary atherosclerosis.