Based on registered cases Н1N1 virus Influenza in Mexico, 26 April, 2009, there were done risk assessment of current and future situations in area along railway across Mongolia. In the frame of this work were done organizational work preparation, urgent activities to prevent the infection The result of this risk assessment were passed this situation with less risk and related activities were done by steps.Work of Making Sure of ReadinessBy the order number 22b of Vice Chairperson of the Security Departure of Railway, on 28th of April, based on act number 02 of the National Emergency Department, group of agents had been assigned on UBRW, on 6th of May ‘’Plan to Prevent and Making Sure Quick Response is Ready from H1N1 Virus Influenza Infection’’ had been declared, announcing to manage works to prevent new virus infections, enforcing presence of related laws and regulations as a duty, organized video-selector of railway on 12th of May 2009, by presenting ways to get infected, prevention, UBRW’s all departments, branches and agencies have organized to prevent. On 29th of June 2009, we have processed and announced a guideline to act when a ‘’Passenger that is suspected with Influenza virus’’, and we made sure international and domestic rails are ready. On 29th of July, with the help of National Infectious Disease Center, we have organized a training to ‘’Early Prevention from H1N1 Virus Influenza Infection Counteract and Preparing Readiness’’ with having presenters from hospitals like Central and Branch rails joint clinic, physicians from branches and factory clinics, Wagon Depo in Ulaanbaatar, Passenger Service Ulaanbaatar Central Station, and produced 63 trainers.In Work of Making Sure of Readiness, on 10th of September 2009, by the order number 50 of Chairperson of Railway, solved 43 million tugrugs of Investment to making sure readiness of the medical and passenger service, saved some protection materials and other inventories. During the red alert additionally planned 156 million tugrugs, during whole phase of H1N1 virus infection UBRW had spent 204 million tugrugs. When looking at the spending: Medical equipments: 73781076 tugrugs, sterilizations and disinfectants: 23907969 tugrugs, protection materials: 27230300 tugrugs, vitamins: 62511518 tugrugs, educational advertisements: 10672525 tugrugs, others: 3369620 tugrugs.Conclusion:1. Incidents of H1N1 virus infection of people in covering area of UBRW’s Central Clinic and its branches railway’s joint clinics are less than National, Ulaanbaatar City, and Provinces that have railways.2. Children ages ranging from 0 to 4 and people from 20 to 49 years old with full ability to work are more likely to get infected.3. According to the research H1N1 Influenza virus incidents are higher in Bayangol and Bayanzurkh districts. The most incidents, which are registered from Bayanzurkh district’s sub districts, are I, III, IV are higher than other sub districts. In these sub districts, Ulaanbaatar Central Railway Station, and commercial centers like BARS Food Market and TOSA Market are located. Moreover 49% of the infected people live in apartments in which they don’t have central how water system, which cannot be denied that, had affected the spread of infections. 4. 96.5-99.15 of all infected people had headache, dry coughing, sneezing, discomfort, chest pain; 76.95 of all children had symptoms like diarrhea. Most patient’s chest X-ray diagnosed one of the two lungs have pneumonia. 60% of all the children and adult from 50 and over had a history of pain and diseases. But youths from 20-49 didn’t have any history of pain and diseases.5. It was effective to use medication tactics like immune activator and anti viral medications.6. In UBRW’s range there haven’t recorded any incidents that are more than 2 people from work place, school and family.7. To conclude (didn’t get laboratory test) from the first registered and dead patient first contaminated 1 person, which had treated in National Infectious Disease Center. And 1 person got lightly sick and got treated at home. If the patient got sick seriously and diagnosed positive, the closest 1 to 2 people have a possibility to be very likely to get contaminated.8. The latency stage of infection was 1 to 3 days and the average inpatient days were 10 days.

The oral hygiene is not relatively good cause of smoking, ignoring oral hygiene, not having enough self-care skills and independent living in case mental illness. Their grinding the teeth, serotonin decreases when the people are depressed and then it makes the carbohydrates increases, loses the sense of taste. Therefore they use a lot of sweet, the salivary output decreases, increase in the number of lactobacili and then it makes the cause ofabnormal disease detections including tooth decay, trigeminus neural pain in temporomandibular joint /TMJ/, oral yeast infection, oral bad breath, burning sensation of the tongue, chronic facial pain. Also the oral can disease detects from drug causes like using the anti-depression drugs for at least 6 months.Using analytical research permanent design, I got 55 patients to take part in the survey who are staying in 5th flat , National Clinic of Mental Health from 22nd of September 2014 until 26th of September. When I do the research for history of their patients: among the diagnosis of 16 people disorder depressed, the 13 patients agreed to have a preventive examination voluntary, one of them declined to do it. I use many methods of researching like questionnaire methods interview method, prevention oforal cavity and clinical examinations, respectively Study shows that curriculum contents of School of Nursing, Mongolian National University of Medical Sciences have comparatively less contents of understanding about healthy person, assessment on human, giving advice healthy human, path anatomy, physiology, communication skills.The most of the survey participant patients have holes in their teeth, gum inflammation, and tongue stress disorder. It shows that it decreased to pay attention on their oral hygiene associated with symptoms and it effects directly related to the decrease in salivary output.Depressed People are so bad at paying attention to their oral hygiene habits.

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: Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change, so we consider to chose to study this topic. Aim: In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result: The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was 1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia 3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%, 5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study. Conclusions In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa), sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods is equally effective for resection of colon pollyps up to 1 cm in size.

Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aim to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy will be performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This will help us to investigate which of the two methods is most prevalent for polypectomy.

Introduction: Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aimed to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy was performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2020 and 2022, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colonoscopy with a high-performance Olympus EVIS EXERA III brand NBI from Japan. In this study, we selected only hyperplastic polyps and adenomas <10 mm in size. Polyps less than 5 mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result : According to the results of the study, in terms of age, the percentage of people having a polyp removed was relatively low among 15-39 year olds compared to the other age groups, while it was higher in those aged >65 years. In terms of body mass index, 75% of the total number of people who had a tumor removed were overweight, indicating that overweight or obese people are at higher risk of developing a colorectal polyps. In terms of gender, 63% of people who had a polyp removed were male, indicating a male predominance in polyp prevalence. The percentage of tumor questionnaires in the total study population was 0% or absent. Early detection of adenomas and hyperplastic polyps, which are precursors of tumor, is the main way to prevent the development of cancer. A slightly raised polyp was present in 53 or 79.1% of the polyps, while a broad-based polyp occurred in 13 or 19% of the polyps, indicating the predominance of the slightly raised polyp in the population. In terms of location, polyps occurred more often in the descending colon and the sigmoid colon, and complications (perforation, bleeding) related to the anatomical structure and location are more likely to occur in these parts of the colon. However, the likelihood of relapse is very low. The procedure time was 17.6 minutes on average, and in 14 cases, hemostatic clamps were placed to prevent the risk of bleeding, and in 5 cases, epinephrine was injected for hemostasis. Early detection of colorectal diseases (endoscopy), changes in the lifestyle of clients, and regular preventive examinations are the main factors to reduce the risk of cancer development, and early start of treatment as well as complete removal of adenoma, an antecedent to cancer, will have a significant impact on cancer prevention and mortality reduction. Conclusions
1. Left sided polyps were commonly diagnosed among study participants.
2. Correlation between the probability of recurrence and the anatomical location of the polyps was very low.
3. Our results suggest that HSP and CSP techniques can be effectively used for the complete removal of 4–10mm colorectal polyps. Moreover, there was no significant difference between CSP and HSP in terms of overall complications.

BACKGROUND. To identify the prevalence of oral lesions in HIV positive group of patients, and to compare their CD4 cell count and viral load to stages of disease progress. MATERIAL AND METHODS. In the present study, we evaluated 30 HIV+ adult patients, attended to the AIDS/STI Department of National Center for Communicable Diseases, Ministry of Health Mongolia. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by Flow Cytometry, as well as viral load by RT-PCR (Amplicor HIV- RNA, TM test 1.5, Roche) RESULTS. 46% of all examined HIV/AIDS patients had oral lesions. Oral Candidiasis constituted the most common lesion, representing 35%, Herpes 22%, followed by Oral Leukoplakia 17%, Necrotizing ulcerative periodontitis 9%, Aphthous Recurrent Stomatitis 13%, Kaposi’s sarcoma 4%. The patients, who have a viral load high exhibited oral lesions related to HIV, independent of CD4 cell count, although patients with CD4+ levels of 233 cel/mm3 were more susceptible to develop these lesions. СONCLUSION. The most common oral lesion was Oral Candidiasis, followed by Oral Leukoplakia and Necrotizing ulcerative periodontitis. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+cell count..

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.

Healthcare is a rapidly growing industry as medical treatments become more sophisticated, more in demand due to increasing incidence of chronic disease and more widely available worldwide. As the amount of healthcare waste continues to increase, there is a need for further research in the field to meet the global demand for proper disposal of healthcare waste. The growing healthcare consumption, driven by various factors, is contributing to the rise in hospital waste, which in turn is putting pressure on current waste management systems.Currently, healthcare institutions manage waste by segregating at the source, safely transporting infectious waste, and disposing of it through incineration, autoclaving, or landfill methods. Both incineration and autoclaving processes have negative environmental and human health impacts. To reduce the amount of healthcare waste generated, it is necessary to train healthcare workers to properly segregate waste according to its type, following established standards.
Governments can take action to improve waste disposal practices, reduce the generation of infectious waste, and ensure that all types of healthcare waste are properly disposed of. This can include:
• Governments should have clear and standardized definitions for both infectious and non infectious healthcare waste, and enhance the regulatory and legal framework to prevent illegal disposal of waste.
• Healthcare institutions should be provided with incentives, financial support, and other measures to reduce hospital waste, with a particular focus on reducing infectious waste in local health institutions.
• Governments should provide research grants to support studies aimed at reducing and managing healthcare waste disposal effectively.
These measures would help improve the overall management and reduction of healthcare waste and ensure a safer and more sustainable approach to waste disposal.