Introduction: Enteroaggregative Escherichia coli (EAEC) is an important agent of acute and persistent diarrhea worldwide. Few cases have been reported in healthy children. EAEC strains are characterized by aggregative adherence (AA) to HEp-2 cells, wherein bacteria are seen in “stacked brick” aggregates attaching to HEp-2 cells and usually to the glass surface between cells. Goal: To identify Enteroaggregative Escherihia coli using multiplex polymerase chain reaction (PCR) and HEp-2 adherence assay in Ulaanbaatar, Mongolia Materials and Methods: A total of 329 E. coli strains were isolated from stool with diarrhea in National Center for Communicable Diseases from July 2012 through September 2014. All specimens were processed by routine microbiological and biochemical tests in the bacteriological laboratories to identify Salmonella spp., Shigella spp. All specimens in our study were negative for these bacterial and parasitic pathogens. The biofilm formation was evaluated by the growth rate of E.coli on plastic surface. PCR assays were used to detect genes of five types of diarrheagenic E.coli (DEC). All of the DEC strains showed mannose-resistant adherence to HEp-2 cells, and aggregative adherence was predominant in these isolates. Bacterial susceptibility to antimicrobial agents determined by the Kirby Bauer disk diffusion method on Muller Hinton agar. Results: EAEC (31.9%) was the most prevalent by PCR and HEp-2 assay comparing with others. EAEC by multiplex PCR in samples (11, 3.3%), followed by enteropathogenic E.coli (EPEC) seen in 2.1%. Enterohemorrhagic E.coli (EHEC) and enteroinvasive E.coli (EIEC) were found in 7 (2.1%) and 1 (0.3%) of the samples. Enterotoxigenic E.coli (ETEC) and diffusely adhering E.coli were detected in 2 (0.6%), respectively. The evaluation of bacterial biofilm formation using 96 well plates showed 309 negative (93%), 15 weak biofilm (4.6%) and 8 moderate biofilm (2.4%) formation for E.coli and no strong biofilm forming strain was detected. Above 50% of antibiotic resistance was observed for ampicillin, trimethoprim/sulfamethoxazole, cefuroxime and cephalotin. Also, 95.4% of isolates were resistant to at least three different classes of antimicrobial agents and considered as multidrug resistance. Conclusion: EAEC is most prevalent pathogen among DEC in our samples. It is necessary to implement EAEC identifying method on Hep-2 assay in our laboratory practice.

Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.

Background: The career and work of medical workers are considered to be the occupation of the highly responsible job of the worldwide. Goal: To identify the percentage of the work-related stress, the burnout, and the symptoms of work-related stress of the physicians and nurses who is working at the critical and intensive care units of UB hospitals. Materials and methodology: The survey was done by quantitative methods and cross sectional design. The study data was collected using the validated questionnaire for the work related stress. The results of the study were analyzed by the Microsoft Excel and SPSS 20 program. Results The response rate was 97.3% The study found that 78.7% of respondents reported having regular stress; and 89.4% of all participants in the survey had a personal burnout, 90.4% had work-related burnout and 94.5% had a high level of client-related burnout.
Physical symptoms include the insomnia 76.7%; psychological symptoms - the headaches 65%; behavioral symptoms as like forgetfulness and annoyance 53.3%; cognitive symptoms as like an increase in sick days or absenteeism by 40% for all physicians and nurses.

Background: Hyperferritinemia, characterized by elevated serum ferritin levels, affects approximately 5–25% of the general population. Given the frequent coexistence of liver iron overload syndrome and metabolic syndrome—both of which significantly contribute to global morbidity and mortality—it is essential to investigate their interconnections. However, there is a lack of sufficient evidence, both in Mongolia and internationally, regarding the relationship between iron storage indicators, metabolic syndrome, and its components. A deeper understanding of iron’s role in disease progression is needed. Aim: This study aims to assess the association between hyperferritinemia and metabolic syndrome parameters. Materials and Methods: A cross-sectional analytical observational study was conducted on 159 male participants who met the inclusion criteria. Data were collected using a standardized questionnaire, and anthropometric measurements were taken. Blood samples were analyzed to determine glucose, triglyceride, total cholesterol, and high-density lipoprotein (HDL) levels using an automated biochemical analyzer. Serum ferritin concentrations were measured via the ELISA method (DRG Instruments GmbH, Germany), with hyperferritinemia defined as a serum ferritin level exceeding 400 ng/ ml. Metabolic syndrome was diagnosed based on the Harmonized criteria. Statistical analyses included the chi-square test and Fisher’s exact test for categorical variables, the Mann-Whitney U test for non-normally distributed data, and Spearman’s correlation test to assess relationships between glycemic levels, lipid parameters, and metabolic syndrome components. Results: The findings indicate that 59 participants (37.1%) had metabolic syndrome, while 33 (20.8%) presented with hyperferritinemia. The presence of metabolic syndrome and hyperglycemia increased the likelihood of developing hyperferritinemia by 3.4 and 3.7 times, respectively, whereas abdominal obesity raised the risk by 2.2 times. Conclusion There was a significant correlation between serum ferritin levels and certain parameters of metabolic syndrome among the male participants in this study.

Background: It is stated in the Government Programme of 2016-2020 that public servants, including health care workers, shall be given a gradually increased salary based on their skill, dexterity, workload, and productivity, and such increase started from 2018 as planned. In the health sector of our country, regarding demand and regulation of the programme, the change shall be made that the system for median salary of physicians and overall staff employed at hospitals gets even constructive, and the required human resource for the sector shall be prepared. Thus, inferring from these claims, median salary, real wage, and socioeconomic condition are in critical need for further evaluation. Objective: To examine the current socio-economic condition of health care workers, and to study the influencing factors at play. Methods: In this study, we used quantitative and qualitative methods. In the survey, we involved 655 health care workers from 6 family health centers, 2 district hospitals, 3 health centers (district-based) in Songinokhairkhan, Sukhbaatar, and Baganuur districts; and Provincial hospital, regional diagnosis and health center, 16 soum health centers from Khovd, Uvs, Arkhangai, Bulgan, Khentii, Dornod, Umnugovi, and Dornogovi provinces, along with 3 National specialized health centers and 1 National central hospital. As for data gathering for the qualitative analysis, 30 focus group interviews and 47 key informant interviews were conducted for the purpose of examining socioeconomic condition, real wage sufficiency of health care workers. Results: Average household income of study participants was 1,880,269 tugrik, the real wage was 1,073,065 tugrik, and the overall household is seen to be composed of 2 different sources on average, namely, self-wage and the income coming from family members or supplement of Child Money Programme. It has come to notice that 19.5% of the participants have lower than average living standard, 89.2% have 2 different loans (mortgage, auto loan or mobile application based loans). Material deprivation index is seen to be 2.73, hence deemed as insufficient. In order to increase the real wage of those workers, it shall be taken into consideration that the basic salary is low, and some financial supplements need to be given. Furthermore, the performance based funding system of health sector is seen to be in need of improvement. Conclusion Real wage of the health care workers is, thus, insufficient. The fact that one in every five workers in this sector have lower than average living standard, and the material deprivation index is 2.73 implying that the financial lives of health care workers are immensely fragile.