BACKGROUNDAccording to WHO statistics of 2013, daily 371,124[1] births, annually 135.5 million [1] births occur worldwide which tends to increase in the following years. In Mongolia, studies that evaluaterelationship between fluid intakes of pregnant women and preterm delivery risk have not been conducted so far to our knowledge. Thus, we aimed to determine this relationship by evaluating first and second trimester fluid intakesof pregnant women in Mongolia.METHODS35 and above years old pregnant women of 24-32 gestational weeks have been included in the study where body measurements and fluid intake were collected via questionnaireand examination.RESULTSWhen we studied the relationship between average fluid intake and preterm delivery risk, having inadequate fluid intake in the first trimester increased the risk of preterm delivery by 5.98 (CI95% 0.89-40.08, p<0.01) fold whereas having inadequate fluid intake in the second trimester increased the risk of preterm delivery by 4.03 (CI 95% 1.06-15.21, p<0.01) foldrespectively.CONCLUSIONSOur results show that low fluid intake in first and second gestational trimesters results in increased risk of preterm delivery significantly in Mongolia.

WHO informed that across world an average of 565 young eople aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological onsequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study nxiety among abused adolescents, some physical parameters and level of cortisol in saliva.Total number of participants were 149 children aged between 11-16 years (number cases were 53, matched control subjects were 96). The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report uestionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, USA. Average age of all subjects in the study was 13.52±1.57 and 102 of all subjects were female and 47 were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (21.3±8.1 ng/ml) statistically significantly lower (p<0.01) than average amount of control group (31.56±16.9 ng/ml). Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.

Background. When the coronary atherosclerotic plaque becomes vulnerable, a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes an acute blood defi ciency in the downstream myocardium. Furthermore oxLDL (oxidized Low Density Lipoprotein) is involved in the coronary atherosclerotic plaque pathogenesis, MMP-9 (Matrix Metalloproteinase-9) enzymes plays role during the plaque rupture and CPR (C Reactive Protein) has a prognostic value in myocardial infarction. Objective. To determine the involvement of oxLDL, MMP-9, CRP markers in the pathogenesis of myocardial infarction, to study their involvement in the injury of the myocardium and to evaluate the complications. Material and Methods. The study was conducted using case-control design. The main inclusion criteria of the 40 case groups are that the patient should have a ruptured coronary atherosclerotic plaque, confi rmed by clinical symptom, ECG, serum troponin I, and coronary angiography. Also 40 patients with coronary stenosis or chronic occlusion without ruptured plague were included in the control group. Serum MMP-9 enzyme and oxLDL titers were determined by ELISA according to the manufacturer’s recommended protocol. Additionally CRP was measured by full-automated analyzater. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease. Results. Serum MMP-9, oxLDL levels (p<0.001) in the case group (ÌÌÐ-9 0.396±0.155 ng/ml; oxLDL 1.411±0.099 μg/ml) were more than in the control group (ÌÌÐ-9 0.223±0.087 ng/ml; oxLDL 1.332±0.163 μg/ml). The logistic analysis shows that ÌÌÐ-9, oxLDL, CRP (MMP-9 OR=0.985, p<0.001; oxLDLOR=0.011, p<0.05; CRP OR=0.041, p<0.005) may play a role in the pathogenesis of the plaque rupture. Serum MMP-9 enzyme level was directly correlated with Gensini score (r=0.552, p<0.01), CIIS (r=0.340, p<0.01) and CRP (r=0.321, p<0.01) titers. Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical signifi cance (p<0.01): the borderline abnormality group (CIIS<10, 0.227±0.099 ng/ ml), possible injury (CIIS 10-15, 0.317±0.132 ng/ml), probable injury (CIIS >15, 0.376±0.132 ng/ ml) groups. MMP-9 levels were signifi cantly higher in the probable injury group patients (CIIS >15) compared to the possible injury group patients (CIIS 10-15) (p<0.001). ROC Curve analysis shows that MMP-9 enzyme levels variance (area=0.87, p<0.001) are more than other biomarkers making it a diagnostically benefi cial for the coronary atherosclerotic plaque rupture (CRP area=0,733, p<0.001, oxLDL area=0.635, p<0.05). Conclusion: Serum MMP-9, oxLDL and CRP are signifi cantly involved in the pathogenesis of coronary atherosclerotic plaque rupture in the myocardial infarction.

Cardiovascular diseases (CVD) are the leading cause of death in the World (31% of all deaths)and Mongolia as well. CVD has been the leading cause of death in Mongolia for the last 20 years and consists one of 3 death cases. In its turn 59.6% of CVD mortality caused by Ischemic heart diseases. When the coronary atherosclerotic plaque becomes vulnerable, it will a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes acute blood deficiency in the downstream myocardium. Some studies indicate that matrix metalloproteinase-9 (MMP-9) plays a key role on pathogenesis of plaque rupture. Aim:To study the involvement of serum MMP-9 enzyme in the pathogenesis during the rupture of the coronary atherosclerosis plaque.The study was conducted using case-control design. The main inclusion criteria of the case group is that the patient should have a ruptured coronary atherosclerotic plaque, confirmed by angiography. The total number of patients is 80, half of them belongs to the case group. MMP-9 was determined in serum by ELISA. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease.The average level of MMP-9 in case and control groups are 0.396±0.155 ng/ml, 0.223±0.087 ng/ ml respectively with p<0.001 significance which shows MMP-9 (OR=0.001, p<0.001) may plays a role in the pathogenesis of plaque rupture. MMP-9 is correlated with Gensini score and CIIS score, respectively (r=0.552, p<0.01; r=0.340, p<0.01) which shows MMP-9 is being elevated with the increase of the severity of coronary heart disease and the cardiac infarction injury. Serum MMP- 9 increases statistically significantly (p<0.001) with the increase of the severity of the stenosis and the number of the affected arteries: no severe stenosis (<75% stenosis) (0.245±0.086 ng/ ml); 1 vessel severe (>75%) stenosis (0.317±0.132 ng/ml), 2 vessel severe stenosis (0.348±0.157 ng/ml), 3 vessel severe stenosis (0.422±0.112 ng/ml). Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical significance (p<0.01): the borderline abnormality group (CIIS<10, 0.227±0.099 ng/ml), possible injury (CIIS 10-15, 0.317±0.132 ng/ml), probableinjury (CIIS >15, 0.376±0.132 ng/ml) group. MMP-9 levels were significantly higher in the probable injury (CIIS >15) patients compared to the possible injury (CIIS 10-15) patients (p < 0.001). An increase in serum MMP-9 enzyme levels is a risk factor of the coronary atherosclerotic plaque rupture (OR=0.001, p<0.001). MMP-9 enzyme may be a possible marker of atheromatous plaque rupture in coronary heart disease.

Background. Cardiovascular diseases (CVD) constitute major cause of death in patients with chronic kidney disease (CKD). It is well established that in decreased renal function is associated with an increased risk of arterial stiffness, so patients with end stage renal disease have a very high risk for cardiovascular events. There have been no reports of the assessment of arterial stiffness in patients at different stages of non diabetic CKD in Mongolia.Aim. The purpose of this study was to determine the correlation between an estimated glomerular filtration rate (eGFR) and cardio-ankle vascular index (CAVI) in the CKD patients. Material and Methods. From a hospital-based population, 125 patients with CKD (mean age 40.30±10.82) were recruited. CKD was evaluated by the eGFR using the Cockcroft-Gault formula. CAVI was determined as an index of arterial stiffness.Results. The mean CAVI was in CKD level l ( 6.00±0.81, p 0.0001), ll (6.90±0.77, p 0.0001), lll (7.42±0.65, p 0.0001), lV (7.63±1.22, p 0.0001) and V (8.02±1.27, p 0.0001). CAVI was negatively correlated significantly with eGFR (r=-0.596, p 0.0001) and age (r=0.543, p 0.0001). Linear regression analysis indicated that CAVI was correlated significantly with eGFR (β=-0.466, p 0.0001) and age (β=0.373, p 0.0001).Conclusion. Decreased eGFR is associated with an increased risk of arterial stiffness, and it could be a strong predictor of risk factor for CVD in CKD patients.

Background: Smoking is significant risk factor for further kidney failure. Haroun et al. found that current smoking was associated with HR of 2.6 for future RRT and having kidney disease listed on the death certificate compared with the former and never smokers [2]. Regarding smoking and kidney pathophysiology, direct vascular effects are probably a major mechanism [3-5]. Smoking is a particularly associated with atherosclerosis. The purpose of this study was to determine the effects of smoking on renal function and arterial stiffness in the CKD patients. Methods: A cross-sectional study was conducted in which adolescents aged 20 to 60 years with CKD total 125 patients with non diabetic CKD (mean age 40.30±10.82) were recruited. CKD was evaluated by the eGFR using the Cockcroft-Gault formula. Cardio-Ankle vascular index (CAVI) was determined as an index of arterial stiffness.Results: Even though there wasn’t an age difference between the smoking and non smoking groups, the renal function (38.1±22.6 vs. 90.5±59.9, p<0.0001) among smokers decreased comparing to the non smokers. The Pearson’s correlation analysis indicated that the smoking index was significantly correlated with the renal function (r=-0.392, p=0.02) and the arterial stiffness (r=0.573, p<0.0001).Conclusion: We found that smoking influenced on renal, it is a significant risk factor of CKD.

WHO informed that across world an average of 565 young people aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological consequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study anxiety among abused adolescents, some physical parameters and level of cortisol in saliva.There were selected 20 abused children and 40 non abused children aged between 11-16 years old and lived in Ulaanbaatar city. The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report questionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, Average age of all subjects in the study was 13.52±1.57 and 59% of them were female and 41% were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (18.65±7.08) statistically significantly lower (p<0.01) than average amount of control group (32.15±20.99).Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.

To determine whether adult people with sleep maintenance problems have significantly melatonin levels comparable normal sleepers. The research was carried out by cross sectional and case-control study. Data were collectedbetween May 2014 and September 2014. We studied 203 healthy adults over the age of 20 years who either slept normally or sleep maintenance problems. A decrease in the quality of sleep is believed to cause anxiety andworsen depression. The quality of sleep was scored using the Pittsburgh Sleep Quality Index (PSQI) a questionnaire method. State and trait anxieties, and depression were scored using other questionnaire methods: the State-Trait Anxiety Inventory (STAI) and CES-D (Center for Epidemiologic Studies Depression Scale), respectively. Serum levels of melatonin were measured in the subjects at 02am, 10am. In the research were involved 126 (62percent) women, 77 (37.9 percent) men and their meanage was 52.24±14.67. 53.7% (n=109) of all subjects were normal sleepers and 46.3% (n=94) were sleep maintenanceproblems. 9.9%(n=20) of all subjects were anxiety, 8.3% (n=17) were depression. Night: day melatonin excretory ratios were similarly in people with sleep maintenanceproblems, normal sleepers have difference.

Sleep is a behavioral state that is a natural part of every individual’s life. To determine the role of health status and social support in the relationship between stresses, depression, anxiety and sleep disturbance, for both intermittent and chronic sleep disturbance. The research was carried out by cross sectional and case-control study. Data were collected between May 2014 and September 2014. We studied 203 healthy adults over the age of 20 years who either slept normally or sleep maintenance problems. The quality of sleep was scored using the Pittsburgh Sleep Quality Index (PSQI) a questionnaire method. State and trait anxieties, and depression were scored using other questionnaire methods: the State-Trait Anxiety Inventory (STAI) and CES-D (Center for Epidemiologic Studies Depression Scale), respectively. All results calculated by SPSS 21.0 programs.The average age was 52.2±14.7 years in our study participants. The rate of self-reported poor sleep quality was found in 46.3% (n=94) of patients according to the PSQI global score (≥5) and53.7% (n=109) patients were normal sleepers. 16.3% (n=33) of all subjects were state anxiety, 9.9% (n=20) were trait anxiety, 8.3% (n=17) were depression. Sleep disturbance was significantly associated with an onset in the evening tea and coffee drinking (OR= 7.0, p = 0.012), majordepressive disorder (OR= 4.2, p=0.015), and stress factors (OR=2.6, p=0.009), meals before going to bed (OR=2.1, p=0.049), but daytime sleep (OR=0.5, p=0.025) is conservation impact.Our results shows, that bad living habits (evening tea, coffee, late sleep and meal habits) depress and stress factors was associated with sleep disturbance, daytime sleep is conservation impact.

Cardiovascular diseases (CVD) are the leading cause of death in the World (31% of all deaths)and Mongolia as well. CVD has been the leading cause of death in Mongolia for the last 20 years and consists one of 3 death cases. In its turn 59.6% of CVD mortality caused by Ischemicheart diseases. When the coronary atherosclerotic plaque becomes vulnerable, it will a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes acute blood deficiency in the downstream myocardium. Some studies indicate thatmatrix metalloproteinase-9 (MMP-9) plays a key role on pathogenesis of plaque rupture. Aim:To study the involvement of serum MMP-9 enzyme in the pathogenesis during the rupture of the coronary atherosclerosis plaque.The study was conducted using case-control design. The main inclusion criteria of the case group is that the patient should have a ruptured coronary atherosclerotic plaque, confirmed by angiography. The total number of patients is 80, half of them belongs to the case group. MMP-9 was determined in serum by ELISA. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease.The average level of MMP-9 in case and control groups are 0.396±0.155 ng/ml, 0.223±0.087 ng/ ml respectively with p<0.001 significance which shows MMP-9 (OR=0.001, p<0.001) may plays a role in the pathogenesis of plaque rupture. MMP-9 is correlated with Gensini score and CIIS score, respectively (r=0.552, p<0.01; r=0.340, p<0.01) which shows MMP-9 is being elevated with the increase of the severity of coronary heart disease and the cardiac infarction injury. Serum MMP- 9 increases statistically significantly (p<0.001) with the increase of the severity of the stenosis and the number of the affected arteries: no severe stenosis (<75% stenosis) (0.245±0.086 ng/ ml); 1 vessel severe (>75%) stenosis (0.317±0.132 ng/ml), 2 vessel severe stenosis (0.348±0.157 ng/ml), 3 vessel severe stenosis (0.422±0.112 ng/ml). Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical significance (p<0.01): the borderline abnormality group (CIIS<10, 0.227±0.099 ng/ml), possible injury (CIIS 10-15, 0.317±0.132 ng/ml), probableinjury (CIIS >15, 0.376±0.132 ng/ml) group. MMP-9 levels were significantly higher in the probable injury (CIIS >15) patients compared to the possible injury (CIIS 10-15) patients (p < 0.001). An increase in serum MMP-9 enzyme levels is a risk factor of the coronary atherosclerotic plaque rupture (OR=0.001, p<0.001). MMP-9 enzyme may be a possible marker of atheromatous plaque rupture in coronary heart disease.