INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.

INTRODUCTION:Waterborne diseases, especially diarrhea, related to water quality and safety, personal sanitation and hygienehave been still reported very high in developing countries. Globally, there are an estimated 1.4 million casesof hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and wateror through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poorsanitation [2].Dysentery is bloody diarrhea, i.e. any diarrheal episode in which the loose or watery stools contain visiblered blood. Dysentery is most often caused byShigella species (bacillary dysentery) or Entamoeba histolytica(amoebic dysentery) [3].Kharaa and Orkhon River are tributaries of the Selenge River-basin, in which many mining and other industries,agriculture, and residential areas reside. It has become a one pollutant factor for water of the Kharaa andOrkhon rivers. As a result, water of the Tuul, Kharaa and Orkhon River was reported to be highly contaminated(Mongolian Human Development Report 2010: Water and Development report) [4].GOAL:The aim of the research was to study incidence of gastrointestinal infectious diseases among population ofsoums are located in Selenge River Basin.MATERIALS AND METHODS:Data on health statistics 2009-2013 years of gastrointestinal infectious diseases, including dysentery, diarrhea,hepatitis A virus and others, were collected and analyzed.RESULTS:Incidence of dysentery was registered highly among people who live in Mandal soums in 2009-2013 years. Butincidence of dysentery (per 10 000 population 2.82) among population ofMandal soum lower than the Selengeprovince and National average. Incidence of hepatitis A virus was registered highly among people who livein Orkhon (74.46), Orkhontuul (48.86) soums and it was greater than 1.3-2 times than the Selenge provinceaverage. Incidence of diarrhea was registered highly among people who live in Khushaat soum and it wasgreater than 2.18-3.8 times the than Selenge province averageCONCLUSION:Incidences of diarrhea and hepatitis A virus were registered highly in Orkhon, Orkhotuul and Khushaat soumscompared to other target soums and it was greater than 1.3-3.8 times than the Selenge province average.Especially, these diseases were registered highly among 0-16 aged children.

Introduction: This article provides areview about techniques and pitfalls of arterialand venous reconstruction during kidneytransplantation. Main reasons of our clinicalstudy are to evaluate vascular variationsof kidney, posttransplantation vascularcomplication incidence and present status ofsurgery outcome.This retrospective researchbased on cross-sectional assessmentofconsecutive 102 kidney transplantation cases,which performed from 2006 to 2015 at theFirst Central Hospital of Mongolia.Materials and methods: Statisticalprocessing andanalysis on posttransplantionpatient history data are made byMicrosoftExcel, SPSS19.0software.Results: Despite rising technicaldifficulties caused by vascular variations,pelvic and inguinal morphology of recipientand the existence of multiple renal arterieskidney transplantation is a safe and highlyefficient procedure.On this article wereexplained 44 kidney transplantation caseswith reconstruction using microvasculartechniques to reconstruct renal arteriesand veins. About 10 different kinds ofreconstructions were done in our practice.Due to investigation of consecutive 102kidney transplanted recipients, 24,51% had avascular anatomical variations. And describedabout 44 vascular reconstructions used inour hospital in case of vascular variations.According to the lit., vascular complicationsranges from 1 to 16%. In our hospital,vascularcomplication of kidney transplantation withmultiple vessels is 4,0-12,0%. Also, incidenceof vascular complication in group with singlevessels from 1.3 to 2.6% and in group withmultiple vessel 4 to 12%.Even it is highcomparing with other international articles;it’s almost in same results. But lymphaticcomplication is higher than others; it showsneeds of careful and accurate dissection ofrecipient site anastomosing vessels.Conclusion: Multiple renal graft’sveselshave been associated with a higher rateof vascular complications, including arterialstenosis and lymphorrhea. It shows needs ofcareful and accurate dissection of recipientsite anastomosing vessels.

BackgroundHuman-induced climate change will affect the lives of most populations in the next decade and beyond. The impact of meteorological conditions on human health has been reported globally. There is a need to conduct surveys for correlation between climate change and human health.GoalTo study the impact of air temperature on human health in selected aimags and city districts.Materials and MethodsIn order to study how climate change and air quality parameters affect human health we selected Zavhan, Selenge, Dornod, and Umnugobi aimags which represent different climate zones and 2 districts of Ulaanbaatar city during 2009-2011. All data for respiratory system disease J00-J99, circulatory system disease I00-I99, were collected from soum, district’s hospital, and aimag and soum’s Department of health.ResultsDuring the study period, a total number of 8649 incidences of respiratory disease are registered. From them 74.2 percent are influenza and pneumonia (J09-J18), 17.6 percent are other acute lower respiratory infections (J20- J22), and 8.2 percent are asthma (J45-J45.9). For cardiovascular disease 15288 incidences are registered. From them 65.6 percent are hypertensive disease (I10-I15), 23.6 percent are ischemic heart disease, and 10.8 percent are cerebrovascular diseases (I60-I69). The lower the air temperature, higher the incidence of influenza and pneumonia, acute lower respiratory infections, hypertensive, and ischemic heart disease.ConclusionsCold weather is correlated with a higher incidence of respiratory and cardiovascular diseases.

Introduction: On January 31, 2020, the World Health Organization (WHO) declared the infection with coronavirus (COVID-19) an “International Public Health Emergency” and on March 11, 2020, declared it a “Pandemic”. To date, the statistics of the total number of cases of COVID-19 infection is more than 676 million, and the number of deaths is more than 6.8 million. Therefore, reducing the mortality and spread of infection is an urgent issue for the world community. In March 2020, Mongolia confirms its first new case of COVID-19 imported by air transport from abroad. Since then, there have been over 1 million total cases of infection and 2,136 deaths. The aim of this study is to determine some outcomes related to the COVID-19 pandemic in Mongolia. Materials and Methods: We used descriptive research design in this study. Quantitative secondary data about causes of total mortality, COVID-19 cases during the pandemic were analysed from Health Development Center. Also, we conducted cross sectional study on concepts of long COVID-19 condition among 188 people who were recovered from their COVID-19 illness. The SPSS-23 software was used to analyze the data. Results: The mortality rate of the total population of Mongolia in 2021 was compared to this indicator for 2010, 2015, and 2020 and its growth rate was calculated. When calculating the mortality rate of the total population of Mongolia, the number of deaths per 10,000 population in 2021 was 47.4, which is an increase of 11% compared to 2020 in terms of growth rate. As for the causes of mortality growth, cardiovascular deaths increased by 16.7%, deaths of injuries and accidents by 8.2%, and deaths of respiratory diseases increased by 61.1% respectively. There was a positive medium correlation (p=0.007) between the number of cases of COVID-19 infection and the population total mortality.
A total of 188 people were included in the study, with a mean age of 38±12.3 years (minimum=18, maximum=70). Females were 51.1% (96), males were 48.9% (92), males were 6.9% (6.9%), and females were 13.3%. Long COVID-19 condition was found in 20.2% of the respondents. The duration of symptoms after infection with COVID-19 was (23.6%) 3 months, (21%) 1 year, and (23.6) still had symptoms. Symptoms such as fatigue, insomnia, cognitive decline (42.1%), shortness of breath (36.8%), cough, and heartburn appeared. Conclusions
1. During the COVID-19 pandemic in Mongolia, the total mortality of the population has increased, including pneumonia and heart attack. Total mortality of the population during the pandemic depended on the number of cases of COVID-19.
2. About one in five people with COVID-19 answered that observed long-term symptoms of COVID-19, such as fatigue, insomnia, shortness of breath, and cognitive changes, which were more common in women and people with chronic conditions.

Introduction: Among the population of Mongolia, cardiovascular diseases (34.2%), cancer (24.3%), accidents and external causes (16.9%) are highly prevalent, and risk factors such as alcohol and tobacco use, unhealthy diet, lack of exercise have increased dramatically, and more than half of people aged 45-64, or 53.2% are at high risk of contracting non-communicable diseases. When comparing the demand for health care and services according to the level of healthcare institutions, it was determined that 70% of the demand is in the primary healthcare institution, 20% at the secondary level, and 10% at the tertiary level. Therefore, in order to prevent these diseases and provide health education to the population, it is necessary to study the attitude of the citizens who visit primary healthcare institutions about public health care and services. Material and Methods: In this study, a cross-sectional research design was used to determine citizens’ attitudes toward public health care and services. In collecting data, a total of 291 people from each of Dornod and Khovd provinces, from the capital of provinces, and 3 soums were included in the target sampling method. When evaluating the attitudes of the respondents, they were rated on a scale of 1-5 for each question. The SPSS-20 software was used to analyze the data. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on the 30th of June, 2022 (Decision #22/05/04). Results: 51% (148) of respondents rated their health status as good and 42.1% (122) rated it as moderate, and 57.6% (167) of all respondents answered that they visit the primary health center when they have symptoms. Also, the status of visiting a primary health center for prevention is better in the following groups: 45-54 age group, among people with complete secondary and higher education, and soum healthcare center.
The attitudes of the participants towards public health care and services were evaluated in 4 groups, which are the demand for organizing preventive measures, the dependence of health on the individual, and the dependence of health on social and economic conditions, with an average of 4 points which means the demand is great. In addition, the healthcare institution’s organization of measures to promote and prevent the health of citizens is an average of 3.87 points, and the general score of the respondents’ attitude is 3.98 points, which indicates that there is a great demand for public health care and services. Conclusions Despite the low number of visits to primary health centers for preventive purposes among the respondents, attitudes toward public health care and services were good.

In recent years, many researches that is related to waterborne diseases, especially diarrhea and water quality, safety, personal sanitation, hygiene have been conducting in developing country. Kharaa and Orkhon river are tributaries of the Selenge river basin and the many industries,agriculture, mining, provinces, soums are located in the near of Selenge river basin. Also Tuul,Kharaa and Orkhon river water is very polluted (Mongolian human Development Report 2010: Water and Development report).The aim of the research is to study correlation between to Kharaa and Orkhon river’s water pollution level and rate of gastrointestinal infectious diseases of people who live in the near of Selenge river basin.We analysed Kharaa and Orkhon river’s water quality and statistical data of gastrointestinal infectious diseases (such as dysentery, diarrhea, hepatitis A virus and others). Then we conducted correlation analysis between to river water pollution level and rate of intestinal infectious diseases. Kharaa and Orkhon river’s water was determined “less polluted” by physical, chemical andorganic indicators. But total number of bacteria was determined highly and Proteus vulgaris,Citrobacter freundi, Enterobacter agglomerans pathogens were detected in these river’s water. There were significant positive correlations between level of nitrit in river water and incidence of dysentery and diarrhea. (r=0.38, p=0.022; r=0.291, p=0.005).

Introduction: Air pollution is one of the greatest environmental risk to health. Ambient air pollution accounts for an estimated 4.2 million deaths per year due to stroke, heart disease, lung cancer and chronic respiratory diseases. Approximately 46% of the population resides in Ulaanbaatar, and over half of the population living in ger (traditional yurt dwelling) areas consumes raw coal, which leads to an increase in ambient air pollutants. The Government of Mongolia took a series of actions to reduce air pollution; one was the ban on the consumption of raw coal beginning on 15 May 2019. The aim of this study is to describe the Ulaanbaatar air quality related to briquettes usage during cold seasons. Material and Methods: We used ecological research design in this study. Quantitative data about air quality of Ulaanbaatar city during the cold seasons (Oct, Nov, Dec, Jan, Feb, Mar, Apr) in 2018-2020 years were analyzed from Department of air quality. These 5 indicators such as sulfur dioxide, nitrogen dioxide, particles (PM_2.5, PM₁₀) and carbon monoxide were selected for statistical analysis. The SPSS-20 software was used to analyze the data. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on 5^th of February, 2021. Results: The average sulfur dioxide, nitrogen dioxide concentrations in the air have increased in October 2019–April 2020 compared to the previous five years. But carbon oxide, particular matter concentrations have decreased in the selected years. Sulfur dioxide (p <0.0001), nitrogen dioxide (p =0.001), PM₁₀(p <0.0001), and PM_2.5 (p <0.0001) are differentiated before and after the use of improved fuels by Wilcoxon signed rank test. However, the CO content did not differ from that of the briquette’s consumption (p =0.412). Conclusions During the cold seasons, the concentration of sulfur dioxide and nitrogen dioxide has increased in air of Ulaanbaatar after used briquettes, while the concentration of particulate matter has decreased during the cold seasons.

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Background: Demyelinating disorders are a group of chronic immune-mediated diseases affecting myelinated axons in the central nervous system, which lead to life-long disability. In Mongolia, the last regional prevalence study was conduct ed in 2010. Our study objective is to describe the current prevalence of multiple sclerosis (MS) and other demyelinating disorders in Mongolia. : Aim Materials and Methods: We registered MS, neuromyelitis optica spectrum disease (NMOSD), myelin oligodendrocyte glycoprotein (MOG), and acute disseminated encephalomyelitis (ADEM) cases diagnosed according to the 2017 McDon ald criteria, the 2023 NMOSD diagnostic criteria, International MOGAD Panel proposed criteria. Results: The study was conducted in all tertiary, 7 regional, and 20 provincial hospitals across Mongolia and has collected comprehensive data on 965 patients. The prevalence of total demyelinating disorders was estimated to be 27.2, MS 15.6, NMOSD 5.6, MOG 0.06, and ADEM 0.9 per 100,000 total population, respectively. The prevalence of demyelinating disorders between provinces was compared in order of geographical latitude, from lowest to highest, and was statistically significant. Latitude is associated strongly with the prevalence of demyelinating disorders (p=0.006, 95% CI 14.3-22.4, Pearson correlation=0.603) and moderately with the prevalence of MS (p=0.028, 95% CI 9.39-15.6, Pearson correla tion=0.503). Conclusion In Mongolia, the prevalence of MS has significantly increased and can be considered at medium risk, but still much lower than that in Western countries. The prevalence of NMOSD is almost similar to other Asian countries. An obvious latitude gradient for demyelinating disorders was observed in the Mongolian population.