First Maternity Hospital in Ulaanbaatar has provided 1890 women, 2508 women and 3728 women in 2012, 2013 and 2014, respectively, for diseases in women. Uterine myoma, ovarian cysts, dysfunctional uterine bleeding, ovariandysfunction and endometriosis are commonly among women. These need to be diagnosed at early stages of the diseases. Endometrial carcinoma is detected in 5% of women under 40 years of age with over amount of hormone estrogen on a base of endometrial hyperplasia.Women with endometrial hyperplasia have 5% possibility to have endometriosis, endometroidcysts, ovarian cancer or uterine myoma and 0.5% possibility to have higher complication of disease. Therefore, we aimed to introduce the practical treatment with cytological analysis as a medical treatment and diagnosis method. The purpose of the research is to highlight the diseases mostly occurring in women, determine cytological changes and differences and improve the differential diagnosis.The research work has been carried out based on reports of cytological analyses undertaken by the National Centre of Pathology for 1310 patients, who were all of patients treated at the Inpatient Care Department in FMH in 2014. This study included in the cytological analyses at the National Centre of Pathology, by using special questinnaries and did retrospective study. 67.7% /888/, 27.8% /365/ and 4.3% /57/ of the above mentioned women were tested with cytological analyses due to surgical diseases, endocrinology diseases and inflammatory diseases, respectively. The average age is 39±58. The uterine myoma, the ovarian cyst and dysfunctional uterine bleeding have been more commonly occurred among the 35 diseases in women as 38.9% /510/, 15.7% /206/ and 16.7%/219/ of the women, respectively. For endometriosis cases, the ovarian endometriosis occurred with 3.7%, the fallopian tube endometriosis occurred 2.4%, the adenomyosis occurred 4.7% and the combined endometriosis occurred 0.5%.Based on the reports of cytological analyses on endometrial hyperplasia, the details show that the simple hyperplasia is 52.4% /178/ and the complex hyperplasia is 47.6% /162/.Compared with women without the HPV, a cervical intraepithelial neoplasia occurs to women with the HPVmore than 20 times. /p<0.001, OR=20.81/. It is statistically important that 2nd stage of adenomyosiscauses atypic cellular changes for 3 times. /p<0.001, OR=3.09/. In women, the uterine myoma, dysfunctional uterine bleeding and ovarian cyst disorders are most common. Average age of women with disease in women is 39.58.Compared with women without the HPV, a cellular change occurs to women with the HPV more than 20 times. /p<0.001, OR=20.81/.The 2nd stage of adenomyosis causes atypic cellular changes for 3 times. /p<0.001, OR=3.09/

Complete seizure control is the single most important determinant of good quality of life for patients with epilepsy and the chronic nature of the disorder requires that antiepileptic drugs (AEDs) be administered for many years, often for a lifetime. Therefore, long-term experience is of particular importance in evaluating the efficacy and safety of an AED. Valproic acid increases γ-aminobutyric acid (GABA) synthesis and release and potentiates GABAergic transmission in specific brain regions and it also has also been found to reduce the release of the excitatory amino acid β-hydroxybutyric acid and to attenuate neuronal excitation mediated by activation of N-methyl-D-aspartate (NMDA) glutamate receptors. In addition to these effects, valproic acid exerts direct actions on excitable membranes, including blockade of voltage-dependent sodium channels. Valproate is generally regarded as a first-choice agent for most forms of idiopathic and symptomatic generalised epilepsies. Many of these syndromes are associated with multiple seizure types, including tonic-clonic, myoclonic and absence seizures, and prescription of a broad-spectrum drug such as valproate has clear advantages in this situation. The elimination half-life is in the order of 9 to 18 hours, but shorter values (5 to 12 hours) are observed in patients comedicated with enzymeinducing agents such as phenytoin, carbamazepine and barbiturates. The most commonly reported adverse effects of valproate include gastrointestinal disturbances, tremor and bodyweight gain. Other notable adverse effects include encephalopathy symptoms (at times associated with hyperammonaemia), platelet disorders, pancreatitis, liver toxicity and teratogenicity. According to the some study results, endocrine manifestations of reproductive system disorders, including polycystic ovary syndrome, may be more common in women treated with valproate than in those treated with other AEDs.

Background. In Mongolia, 320-350 people died per year due to traffic accidents. About 193 people were died in road of rural area. According to statistic, focusing on the accidents’ reason, about 94.9 percent of accidents are caused by faulty operation of driver and 0.4 percent is caused by road condition. Goal. The purpose of this study was to analyse the influence of road condition on the route Ulaanbaatar- Baganuur, where traffic accident have frequently occurred and through that find solutions to relieve the traffic accidents.Materials and Methods. Traffic safety was evaluated with coefficient of traffic safety that defined as divide the safe speed of vehicle on the road with invisible area such as crest and sag vertical curve and horzintal curve to the speed of vehicles from opposide direction. The average speed of vehicle on hill by having invisible of road curve inside, the end of road ascent and the road section that broke road asphalt surface were determined by stability and steering dynamic calculation.Result. According to the study, on the route Ulaanbaatar-Baganuur, within last three years, about 37 accidents were occurred. Accidents and conditions on the 14 stretches where accidents have frequently occurred were studied and analyzed by repetition, location and road condition and similarity of neighbor points, so on the 14 stretches, the accidents were occurred frequently. From those accidents, 24 people died and 87 people were injured. Classifying the accidents with 14 stretches, about 14 percent of accidents were occurred on the end of road ascent; 28 percent on straight section; 35 percent on curve; 16 percent on broken surface section of road; 7 percent on the place that road asphalt surface was missed partially. Decreasing the average speed of vehicle to 54.6 km/h on hill by having invisible of road curve inside, 64.2 km/h on the end of road ascent and 51.5 km/h on the road section that broke road asphalt surface were required.Conclusion. The coefficients of traffic safety are had between 0.30-0.81 on the sections that required limiting the traffic speed. In other words, the technical environment of traffic accidents consists on some points of this road.

Introduction: Although bacterial vaginosis prevalence varies across countries and populations, recent systematic reviews and meta-analyses indicate that 23–29% of women of reproductive age are infected. Each year, 21.2 million (22.9%) women between the ages of 14 and 49 in the United States develop bacterial vaginosis. Microenvironments are interconnected with the endocrine, immune, and other organ systems and dependent upon external and internal environmental influences. In women between the ages of 15 and 44, bacterial vaginosis is the most common vaginal disorder, according to the Centers for Disease Control and Prevention.
In our nation, 93.4% of women who are of reproductive age have vaginalis; the percentage of cases with Gardnerella vaginalis alone is 22.6%, and 53.1% have it in combination with other anaerobic bacteria, which is a significant percentage. Our research is based on the lack of information about the vaginal environment of Mongolian women and factors influencing changes in the microenvironment. Our research is based on the lack of information about the vaginal environment of Mongolian women and factors influencing changes in the microenvironment. Goal: The objective is to study how age relates to the development of bacterial and fungal vaginitis through the analysis of vaginal swabs. Materials and Methods: For our study, we selected 100 women aged 20-59 through targeted sampling from clients who underwent vaginal smear tests at “Yu Bi Lab” laboratory and “Tsetsuu” diagnostic center in Ulaanbaatar in 2023. Vaginal smear analysis was conducted using Nugent’s criteria and Gram staining. Statistical analysis was performed by comparing pathogens among the participants based on age using Pearson’s correlation method. We obtained permission to conduct research.
Through the Etugen University Biomedical Ethics Comittee convention held on march 11,2024 Results: The study divided 100 women into four age groups to examine the vaginal environment with their age and the factors influencing it. The research aimed to understand how bacterial vaginitis and fungal vaginitis evolve during reproductive age and menopause. Among the age groups, women aged 20-29 had an average of 5.59±3.35 epithelial cells (n=32), those aged 30-39 had 6.10±3.29 (n=37), women aged 40-49 had 6.70±3.90 (n=17), and women aged 50-59 had the highest number of epithelial cells at 9.42±8.19 (n=14), representing 34% of the group. Conclusion
1. Women of reproductive and menopausal age experience changes in the vaginal environment due to various factors. This includes a decrease in the ratio of normal microorganisms and lactobacilli, an increase in the number of conditional pathogens, and the development of an alkaline environment in the vagina.
2. Bacterial vaginitis predominantly affects younger women, with symptoms often being subtle. In contrast, fungal vaginitis is more common among menopausal women. Lower estrogen levels in women in this age group cause lactobacilli to break down glycogen less efficiently into lactic acid, even though the number of lactobacilli is still normal. This research implies that suppositories and estrogen pills may help treat these problems for women between the ages of 40 and 59.

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).

Postmenopausal estrogen deficiency can lead to genitourinary syndrome of menopause (GSM), which manifests as vaginal dryness, dyspareunia, and sexual dysfunction, among other clinical symptoms. These complications often result in emotional distress and a decline in overall quality of life (7). Several studies estimate that 25–50% of postmenopausal women experience symptoms such as pain during intercourse, burning, itching, and dysuria due to vaginal atrophy and inflammation (9). Menopause is commonly diagnosed based on the absence of menstruation and hormone levels (10), but one of the simplest diagnostic methods is the evaluation of the vaginal microenvironment. There is limited data in Mongolia regarding the vaginal microenvironment of perimenopausal and postmenopausal women and the factors influencing its changes. This gap in knowledge formed the basis of our study. The aim of this research was to assess the vaginal microenvironment in menopausal women and to analyze its relationship with various influencing factors. We conducted a cross-sectional observational study using a descriptive research design. A total of 110 women aged 45–55 years, presenting with menopausal symptoms at “Santmaral” Women’s Clinic and the Women’s Outpatient Department of Songinokhairkhan Health Center, were selected for the study. Both quantitative and qualitative research methods were employed, including surveys and physical examinations. Participants completed a 10-minute questionnaire consisting of 8 open-ended and 12 closed-ended questions. The vaginal microenvironment was assessed using special pH test strips applied to vaginal secretions. Data were analyzed using Excel 21 and SPSS 23, comparing the vaginal microenvironment with various influencing factors. The results showed that the average vaginal microenvironment pH among menopausal women was 5.18 ± 0.45 (n=110). In married women, the average pH was 5.1 ± 0.45; among women with a history of pregnancy, it was 4.10 ± 1.58; and among those who had given birth, it was 2.8 ± 0.98 — indicating an abnormal vaginal microenvironment. Women who were using hormone replacement therapy had an average pH of 5.05 ± 0.45, while those using non-hormonal contraceptive methods had an average pH of 5.3 ± 0.43. These findings were statistically significant (p = 0.0001****)

Introduction: Lung cancer is the leading cause of cancer-related deaths in the world, and half of all new cases (59.6%) are recorded in Asia. Smoking remains the leading cause of death from lung cancer and COPD, followed by air pollution. Therefore, in Ulaanbaatar, where the population concentration is high and air pollution is high, there is a need to study the new cases and deaths of lung cancer in detail. Purpose: It is aimed to evaluate the prevalence of new cases and deaths of lung cancer among the population of Ulaanbaatar. Materials and Methods: This study analyzed new cases and deaths diagnosed with lung cancer from 2013 to 2023 in the city of Ulaanbaatar using a single-moment design of descriptive research. The quantitative data of the study included the diseases recorded using the International Classification of Diseases X (ICD-10) and lung cancer codes C-33 and C-34. The numerical data collected during the research were processed in the Microsoft Office Excel-13 program and processed using the IBM SPSS Statistics 23 program. Results: A review of the newly registered lung cancer epidemic in Ulaanbaatar from 2014-2022 has observed an increase in the number of new cases recorded in Songinokhairkhan, Sukhbaatar, Khan-Uul, and Baganuur districts in those years and in recent years in the Bayanzurkh and Sukhbaatar districts. Men were three times more likely than women to develop lung cancer, with new cases and deaths highest in the 55-69 age group. The cancer diagnosis was diagnosed using imaging devices. Of the total cases diagnosed, 9 out of every 10 people diagnosed are diagnosed later, or 3.4 per cent, and 69.5 per cent are diagnosed with jumping stages. Conclusion Although the number of new cases and deaths among the population of Ulaanbaatar is relatively lower than the national average, there has been an increasing trend in recent years.

BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy. OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population. METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group. RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis. CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).