BACKGROUNDPhysical, mental and gross motor development occur intensively during the childhood. Therefore it is important to detect any developmental delays early in order to take proper intervention which is significant for mental ability and personal development of a child. In this study, we aimed to evaluate mental and gross motor development of the kindergarten’s children in Bayanzurkh and Khan-Uul district.METHODSWe selected 157 children, aged from 3 to 6 years, from Bayanzurh district’s kindergarten and 125 children from Khan-Uul district’s kindergarten randomly. Population basedcross sectional study design was used. Mental and gross motor development was measured by Denver-II test. Statistical analysis of the collected data was conducted using SPSS 17.0 software program.RESULTSLanguage development delay, fine motor-adaptive development delay, gross motor development delay and personal-social development delay were observed in 42%, 15%, 12%, 8% of the kindergarten children, respectively.CONCLUSIONSWe conclude that it is imperative to pay more attention to mental, language and gross motor developments of children in kindergarten.

BACKGROUND: One of the confronted problems of health branch of Mongolia is to confirm pregnancy and delivery to health of mother and baby and to decrease early neonatal mortality and stillbirth. Rate of perinatal mortality becomes real index of health and quality of health care. In the world more than 6 million perinatal mortality and 2.6 million stillbirths occur in 1000 birth every year. In Mongolia last year’s birth increases and perinatal mortality hasn’t been decreased yet. By 2013 perinatal mortality of country and aimag 14.4 per 1000 birth, in eastern and khangai and central regions and Ulaanbaatar (UB) city it is fewer than the above mentioned average, but the western region it is 17.5 or 3.1 î/îî higher than average rate. GOAL: To study current situation of perinatal mortality in western region of Mongolia MATERIAL AND METHODS: On the base of statistical dates of perinatal mortality of Health indicators and dates of health authorities of western region of Mongolia in 2004-2013 we considered indications of stillbirth from 22 weeks of gestation and early neonatal mortality by trend criteria. RESULTS: In the period of last 10 years in the western region of Mongolia totally 94810 mothers gave a birth, perinatal mortality is 2347 or 24.7 per 1000 birth. 57.7% of total perinatal mortality is stillbirth and 42.3% is early neonatal mortality. Among 5 aimags of region in Bayn-Ulgii stillbirth is the highest (77.2%), in Gobi-Altai aimag early neonatal mortality is the highest (70.3%). Dates show that perinatal mortality rate is different among western region’s aimags. Trends of Mongolian western region’s perinatal mortality rate till 2016 years will increase in Zavkhan aimag by 8.6, and in Khovd aimag by 0.9; and in other aimags will decrease. CONCLUSION: Although perinatal mortality decreases in western region of Mongolia, it is always higher than average rate of country. Therefore it is necessary to improve quality of antenatal and prenatal care. By doing this trend of increasing and decreasing will become stable and further it will be decreased.

Glucose-6-phosphatase dehydrogenase (G6PD) deficiency is the most common enzyme deficiency in humans, affecting 400 million people worldwide and a high prevalence in persons of African, Middle Asian countries. The most common clinical manifestations are neonatal jaundice and acute hemolytic anemia, which is caused by the impairment of erythrocyte’s ability to remove harmful oxidative stress triggered by exogenous agents such as drugs, infection, or fava bean ingestion. Neonatal hyperbilirubinemia caused by glucose-6-phosphate dehydrogenase (G6PD) is strongly associated with mortality and long-term neurodevelopmental impairment. Aim:To determine a level of glucose-6-phosphate dehydrogenase in healthy neonates.The 76.5% of all participants (n=205) was assessed 4.36±1.15 Ug/Hb in normal reference range of G6PD other 23.5% (n=63) was 0.96±0.51 Ug/Hb with G6PD deficiency. In the both sex, 51.5% of male 0.88±0.46Ug/Hb (n=33) and 47.6%of female (n=30) 0.97±0.55Ug/Hb was assessed with G6PDdeficiency. Developing Jaundice period in number of 63 neonates with G6PD deficiency, 85.7% of neonates (n=54)was in 24-72 hours, 4% of neonates (n=3) was in 5-7 days and there is no sign of jaundice in 9% (n=6).Therefore neonates with G6PD deficiency, 53.9% (n=34)contiuned jaundice more than two weeks.G6PD deficiency was determined in male neonates (51.5%) more than female(47.6%). The 76.5% of all participants (n=205) was assessed 4.36±1.15 Ug/Hb in normal reference range of G6PD other 23.5% (n=63) of all participants was 0.96±0.51 Ug/Hb with G6PD deficiency. It shows that G6PD might be one potential risk of neonatal jaundice and hyperbilirubinemia in neonates in Mongolia.

JUSTIFICATION: According to the World Health Organization (WHO), 6.6 million children under the age of five died in 2012 - more than 750 every hour. Most of these children could survive and thrive with access to simple, affordable interventions. The loss of a child is a tragedy - families suffer and human potential is wasted. WHO is improving child health by helping countries deliver integrated, effective care in a continuum, starting with a healthy pregnancy for the mother, through birth and care up to five years of age. Investing in health systems is important to delivering this essential care [1, 2]. GOAL: To study perinatal mortality, this is the most important reason of infant mortality in Mongolia. MATERIALS AND METHODS: A retrospective cohort study was conducted reviewing data from 2007-2011 using the ICD code P00-P96 [4] listing “certain conditions originating in the perinatal period”. Data was analyzed using Epi-Info 2000 and GIS software. RESULTS: Data from 2007-2011 showed that 3091 neonates died from conditions originating in the perinatal period and of these 58.7% (1814) were males. Furthermore, the results of this study showed that the leading causes of death were “respiratory and cardiovascular disorders during the perinatal period” (ICD code P20-P29). More specifically, the causes were: - Birth asphyxia (P21) - Respiratory distress of newborn (P22) - Congenital pneumonia (P23) CONCLUSION: National average deaths per 1,000 live births in Mongolia are 9.5—with the highest rates reported in Dornogovi, Uvurkhangai, Bayankhongor, Gobi Altai, Uvs, Zavkhan and Khovsgol.

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.

BackgroundOpen cardiac surgery in CPB condition has increased dramatically in the recent 5 years. Therefore,multidisciplinary researches are needed on this new technological method. The surgical results andperioperative complications depends on keeping normal level of homeostasis parameters during CPBin the open heart surgery.Materials and MethodsTo study the influence of blood cardioplegic and Del Nido’s solution on homeostasis duringcardiopulmonary bypass, we concluded retrospective sample survey using CPB reports from 535 patients,who underwent cardiac surgery with CPB between 2008 and 2012, in 3rd Hospital’s cardiovascularsurgery department.We calculated average parameters of homeostasis, and studied an aortic cross clamp, CPB time,hemodilution and heart recovery process, on three stages of the surgery.We did comparative study on 21 cases of children, who went under congenital heart disease surgery;using Del Nido’s and blood cardioplegic solution.ResultIn recent 5 years, artery blood indicators were pH=7.45±0.06, paCO2=28.8±5.86 mm.Hg,paO2=398.3±99.33 mm.Hg, BE=-4.15±2.51 mmol/l, HCO¯3=20.57±2.18 mmol/l, Ht=28.15±5%,K+=4.12±0.87 mmol/l and Na+=140±3.22 mmol/l during open cardiac surgery in CPB condition(n=535).In case group (n=21), these indicators were pH=7.33±0.09, paCO2=37.49±12.11 mm.Hg,paO2=465.76±77.54 mm.Hg, BE=-6.2±2.78 mmol/l, HCO¯3=20.44±2.46 mmol/l, Ht=27.38±5.12%,K+=3.65±0.46 mmol/l and Na+=141.22±2.64 mmol/l. In control group (n=21), above results werepH=7.40±0.07, paCO2=28.52±6.34 mm.Hg, paO2=394±88.92 mm.Hg, BE=-5.52±2.37 mmol/l,HCO¯3=18.84±2.39 mmol/l, Ht=27.66±3.52%, K+=3.86±0.66 mmol/l and Na+=141.2±3.22 mmol/l.Conclusions:1. When acid and alkaline balance was normal during CPB, hyperoxia and hypocapnia are appearedthrough gas analysis (p=0.0001). Metabolic acidity and hyperoxia showed up in the case group, whohad used Del Nido’s solution (p=0.0001).2. As the beginning of CPB, patient’s hematocrit is reduced by 10.26% (p=0.0001). The influences ofboth Del-Nido and blood cardioplegic solutions are the same on hemodilutes (p=0.26).3. While blood cardioplegic solution is used, heart is refreshed with 80.3% sinusial rhythm(p=0.0001).4. Aortic cross clamp time and increases repetition of cardioplegic solutions are correlated with cardiacrecovery time positively (r=0.445, p=0.0001, n=520).

BackgroundOpen cardiac surgery in CPB condition has increased dramatically in the recent 5 years. Therefore,multidisciplinary researches are needed on this new technological method. The surgical results andperioperative complications depends on keeping normal level of homeostasis parameters during CPBin the open heart surgery.Materials and MethodsTo study the parameters of homeostasis during cardiopulmonary bypass, we concluded retrospectivesample survey using CPB reports from 535 patients, who underwent cardiac surgery with CPB between2008 and 2012, in 3rd Hospital’s cardiovascular surgery department.We calculated average parameters of homeostasis, and studied heart recovery process.ResultIn recent 5 years, artery blood indicators were pH=7.45±0.06, paCO2=28.8±5.86 mm.Hg,paO2=398.3±99.33 mm.Hg, BE=-4.15±2.51 mmol/l, HCO¯3=20.57±2.18 mmol/l, Ht=28.15±5%,K+=4.12±0.87 mmol/l and Na+=140±3.22 mmol/l during open cardiac surgery in CPB condition(n=535).80.3% of patients’ heart spontaneously recovered and stabilized with sinus rhythm. 16.4% of them wererecovered with fibrillation while 2.1% of them were recovered with adrenomimetic support and 1.2% ofthem were recovered with strong adrenomimetic support and defibrillation.Conclusions:1. When acid and alkaline balance was normal during CPB, hyperoxia and hypocapnia are appearedthrough gas analysis (p=0.0001).2. While blood cardioplegic solution is used, heart is refreshed with 80.3% sinusial rhythm(p=0.0001).

Introduction: According to the 5th National Nutrition Survey, 6.1 percent of all children were stunted and 1.4 percent had severe stunts. Stunts are a manifestation of chronic nutrition disorders caused by repeated and chronic diseases, not having adequate nutrition for a long time.
The National Nutrition Survey, published in the National I-V study, assesses the nutritional status of under-five children. However, studies on nutritional, nutrient, and safety in children are not yet available. Therefore, it is necessary to study the nutritional and nutritional qualities of children in kindergartens. Goal: To evaluate the nutrition of children in the kindergarten, calories and nutrients, and evaluate whether they meet the established norms. Material and Method: The survey covered 96 kindergartens. Survey data based on food expenditure report of kindergarten, were processed by Microsoft Excel. Calories and nutrients are calculated by calculation method. Results: The use of milk and dairy products for children in kindergartens was 1.1-1.8 times, flour product consumption was 1.5 times, vegetable consumption was 1.7 times, fruit consumption was 4.1 times lower than the approved recommendations.
The consumption of meat and meat products for children was 1.2 times, rice consumption was 1.6 times, sugar and sweet products was 1.4 times higher than the approved recommendations.
The number of protein for children in kindergartens is 1.2, fat is 1.1, carbohydrate is 1.3 times less, and feeds averaging 1038.6 kcal per day, which is 310.6 kcal less than the approved recommendation. Conclusion Kindergarten children cannot get sufficient quantities of milk, dairy products, fruits The amount of meat, flour, rice, and sweet foods for children of the kindergarten is greater than the recommended size.
The calorie of diet for children in kindergarten is less than 310 calories from the recommended level

Bacterial infection continues to be the major cause of morbidity and mortality in the newborn of the developing countries. In Mongolia, 46% of deaths in neonates were due to sepsis in the period of 2004-2007. In Ulaanbaatar city 49.3% of late neonatal deaths were due to sepsis. Because the prognosis for sepsis largely depends on early identification and treatment, these neonates are subjected to extensive diagnostic evaluation and empirical systemic antibiotic treatment, pending laboratory results. Neonatal Sepsis is most likely to be caused by group B streptococci in developed countries and E. coli, Klebsiella sp. and Enterobacter sp. in developing countries. Methods. The present prospective study was performed in the neonatology unit of a tertiary-care Maternal and Child Health Resear Center after obtaining approval from the institutional ethics committee. Ninety seven neonates, ranging from birth to 30 days old, at risk of bacterial infection were evaluated. Risk factors were based on abnormal feto-maternal clinical findings, as described in standard textbooks of neonatology. One hundred and fifty two neonates with absence of feto-maternal risk factors were included in the present study as controls. This was to highlight the basic difference in the values of haematological parameters between neonates clinically suspected of infection and those who were without any risk factors. An extensive perinatal history, as well as a complete record of clinical signs and laboratory data, were recorded in each case. Blood samples were obtained from peripheral venipuncture in all neonates within 24 h of admission, before initiation of antibiotic therapy. Conclusions: 1. Most common risk factors of neonatal sepsis are maternal bacterial vaginosis (OR=5.7), kidney disease during pregnancy (OR=2.4), gestosis of pregnant women (OR=3.2), maternal infectious disease (OR=2.3), and anemia (OR=1.6). 2. Enterobacteriaceae was the most common organism isolated (55%), followed by Escherischia coli, and Klebsiella. 3. Among 73% of neonatest the clinical signs of sepsis were identified during the early neonatal period, 62% of them during the first 3 days of life. The common clinical type of neonatal sepsis was hypoergetic. 4. 60% of neonates were preterm and 44% were LBWI. 5. The haematological findings significantly associated with sepsis and their comparison with the values recommended. 6. A haematological score can be obtained by a complete blood count and examination of peripheral blood smear, thus permitting an objective assessment of haematological changes that occur in a neonate suspected of sepsis.

PurposeThe aim of our study is to investigate the relationship between cognitive status, depression level,functional status and quality of life in elderly people living at home and in Batsumber.Methods158 voluntary elderly subjects, older than 60 ages were included in the study. The data was obtained byface to face interviews. The questionnaire covered socio-demographic characteristics, administrationof the standardized Mini mental test (SMMT), Geriatric Depression scale (GDS), Lawton instrumentalactivities of daily living (IADL) scale and World health organization Quality of life instrument-olderadults module (WHOQOL-OLD). Data analysis was performed using SPSS 22 software.ResultsThe living at their own home subjects (77.4%) had a high cognitive level and the living in nursing homesubjects (88.2%) low cognitive level. In both groups appeared in high levels of depression. Therewas a positive correlation between IADL, cognitive status and quality of life (p<0.05) and a negativecorrelation between cognitive status, quality of life and depression status.Conclusion: Our results suggest that elderly are more susceptible to the risk of developing psychiatricproblems especially depression. And this study indicated importance of the relationship betweenfunctional level, cognitive status, depression level and quality of life of elderly people living at homeand in Batsumber.