Selenium was discovered by the Swedish chemist Jo¨ns Jacob Berzelius in 1817 and has been recognized as an essential trace element for many life forms including man since 1957. As an essential trace element, the importance of selenium (Se) in humans is well established, and its deficiency has caused serious health effects in humans, such as Keshan disease. Foods are major natural source of Se, and its levels generally depend on soil Se levels. Since its discovery as an important component of antioxidant enzymes, such as glutathione peroxidase (GPx), thioredoxin reductase (TrxR) and iodothyronine deiodinases (IDD), there has been an increased interest in the study of other Se-containing proteins (selenoproteins) or enzymes (selenoenzymes)].Selenocysteine is recognised as the 21st amino acid, and it forms a predominant residue of selenoproteins and selenoenzymes in biological tissues. The molecular structure of selenocystiene is an analogue of cysteine where a sulphur atom is replaced by Se. Selenium can be measured in whole blood, blood fractions (plasma, serum, red blood cells), hair, nails, and urine. Plasma selenium levels below 0.6mM (40–50 ng/ml) are considered deficient, and risk of toxicity occurs at levels higher than 2mM (160 ng/ml), with reports of toxic effects at concentrations higher than 3mM (250 ng/ml)The increased production of ROS (reactive oxygen species) can exert oxidative stress in the physiological system, and if excess ROS are not properly regulated they can cause damage to cellular lipids, proteins and DNA. The damage caused by ROS has been linked to various human diseases, including heart diseases. The presence of ROS can also cause the oxidation of lowdensity lipoprotein (LDL),and it has been reported to be associated with initiation of atherogenesis in heart diseases. One hypothesis is that the presence of high Se as antioxidant selenoenzymes and selenoproteins may help to reduce the production of oxidised LDL and, therefore, would reduce the incidence of heart diseases.Thioredoxin reductase plays a significant role in preventing the development of atherosclerosis by reducing oxidative stress and increasing NO bioavailability

IntroductionOne key target of the United Nations Millennium Development goals is to reduce the prevalence of underweight among children younger than 5 years by half between 1990 and 2015. Child malnutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. World Health Organization estimated the malnutrition was associated with 54% of child deaths in developing countries. The devastating effects of malnutrition on human performance, health, and survival are well-established and a recent global analysis demonstrated that child malnutrition is the leading cause of the global burden of disease. The importance of assessing population nutritional status every 5 years is widely recognized, and three rounds of National Nutrition Survey were carried out in Mongolia since 1992 with support from UNICEF. The most recent Third National Nutrition Survey was carried out with the purpose of assessing nutritional status of Mongolian children and women six years ago in 2004.ObjectiveTo describe the national prevalence of underweight in children under five.Materials and MethodsThe current cross-sectional survey was conducted in 21 provinces of 4 economic regions of the country and capital Ulaanbaatar city. Household was randomly selected based on local administrative and soum/family hospital registry and enrolled a total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey. Child growth was assessed based on z-scores calculated using the WHO Child Growth Standard. Low weight-for-age (underweight) can result from either long-term or short-term nutritional deficit.Results4.7% of the surveyed children were underweight. According to the WHO criteria the prevalence of underweight in Mongolian children less than 5 years of age was include “low prevalence rate”. The prevalence of the underweight among children less than 5 years was significantly higher in Rural area than the Urban.Conclusions:1. The national prevalence of underweight remains at “low” level according to WHO classification. 2. Child malnutrition reduction is needed to successfully meet the Millennium Development Goals.3. In rural area the prevalence of underweight among in 0-59 months old children was highest than urban area’s children.4. The prevalence of nutrition deficiencies varies between different regions calling for implementation of interventions specific for local conditions and needs.

Introduction. More than 3.5 million mothers and children under five die unnecessarily each year due to the underlying cause of under nutrition, and millions more are permanently disabled by the physical and mental effects of a poor dietary intake in the earliest months of life. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. It has been established that to reduce child mortality and to prevent illnesses related to malnutrition the most effective actions are to breastfeed, feed with proper complementary foods, enrich child’s diet with vitamin A, zinc and other necessary vitamins and mineral supplements, and to treat chronic malnutrition. This can be achieved by implementing internationally reputed projects and programs. Goal. To assess the knowledge, attitude and practice of mothers in the project areas towards, infant and young child feeding.Materials and Methods. This survey conducted in each of 5 soums of Gobi-Altai, Sukhbaatar, Dundgobi, Tuv, and Arkhangai aimags and each of 5 khoroos of Chingeltei and Songinokhairkhan districts of Ulaanbaatar city. Survey recruited a total of 1077 mothers and caregivers of children aged 0-35 months.Results. 7 in 10 mothers participating in the study have “insufficient” level of knowledge of feeding young children and this is related to the mother’s education level. 2. 21.8% of mothers and caregivers were aware of the recommendations of breastfeeding the child within an hour after birth and 38.6% were not aware of exclusive breastfeeding until 6 months of age. 1 in 4 mothers participating in the survey (25.2%) had the wrong understanding of feeding a child 1-2 times a day while complementary feeding: 43.6% of mothers in Sukhbaatar aimag, and 33.8% in Gobi-Altai aimag had this insufficient knowledge of frequency of breast feeding while giving complementary food to the baby. Half (50.3%) of mothers and caregivers did not know the correct amount of food to be given at one time to feed a child and this knowledge was insufficient across all aimags and districts. Knowledge of illnesses caused by nutrition and their preventions was insufficient among mothers in all aimags and districts.Conclusions:1. 65, 7% of mothers exclusively breastfed their children until the age of 6 months. The percentage of exclusively breastfeeding in districts is similar to the national average; however, in rural aimags it is twice higher.2. Only 41, 5% of children up to 3 years of age were fed with complementary food at right time, while 42, 8% - too early and 15%- too late.3. Only 8, 7% of mothers and caretakers have correct practice of feeding children of 12-23 months old more than 5 times per day, which is not sufficient indicator.

Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.

: Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Globally, the prevalence of obesity and overweight tripled in the child and youth populations from the mid-1970s (about 4%) to 2016 (greater than 18%). In 2016, more than 330 million children and adolescents were affected by overweight or obesity globally. It is estimated that by 2030 nearly 30% of all children will be affected by overweight or obesity. For this reason, childhood obesity is a major public health problem worldwide.
This study summarizes and reviewed research findings related to childhood obesity and health risks. Overweight and obesity are defined as an abnormal or excessive accumulation of fat that can harm health. Obesity has a multifactorial origin that involves both genetic and environmental factors. Several studies showed that excess body fat increased the risk of multiple comorbidities, such as high blood pressure, coronary heart disease, type 2 diabetes, insulin resistance, and cancer. According to the results of the research, the mother's nutritional status and obesogenic environments have a great influence on childhood obesity. A summary of the results of many studies concluded that childhood obesity is more likely to develop non-communicable diseases in adulthood. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2–4 years has increased moderately. Overweight or obesity during childhood has important short-term and long-term consequences. Conclusion In recent decades, the prevalence of obesity in children has increased dramatically. For the successful implementation of activities to prevent overweight and obesity in children, it is necessary to create a supportive environment and to promote health.

Нойр булчирхайн цочмог үрэвсэл, эмнэлзүйн урьдчилан тооцоолох дүрэм, Ranson –ийн шалгуур, APACHE II-ийн шалгуур A clinical prediction rule is a type of medical research study in which researchers try to identify the best combination of medical sign, symptoms, and other findings in predicting the probability of a specific disease or outcome. More than 80% of all patients with acute pancreatitis recover promptly without developing severe pancreatitis. The presence of early organ failure (within 24 hours of admission), multiple-organ system failure, and persistent or progressive (present beyond 48 hours after admission) organ failure are associated with prolonged hospitalization, ICU admission, need for surgery, and death. In high developed country, Ranson and APACHE II prognostic criteria are used in order to evaluate patient´s situation and modified treatment tactics. That is give an idea us to carry out retrospective study, by using patients´ documents, who hospitalized in National central hospital in last year. As result, according to Ranson´s criteria 13 (31.7%) of all patients had 0-2 score, which means mortality risk was 1.8%, 20 (48.8%) had 3-4 score (mortality risk is 11%), 8 (19.5%) were estimated 5-6 score, having 33% of mortality risk. Whereas, regarding to APACHE-II criteria 14 (34.2%) of total patients had score of 0-4, showing 4% of mortality risk, 23 (56.1%) were scored 5-9, having 8% of risk, 3 (7.3%) were scored 10-14, having 15% of risk, 1 (2.4%) had 15-19 score, having 24% of risk. Moreover, we determined that incomplete laboratory test, meaning essential prognostic criteria not used in Mongolia.

Background: Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth weight (defined as less than 2500 grams) poses a range of serious health risks for children. Objective: To assess the prevalence of low birth weights (LBW). Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. For the selection of households in urban areas, the process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child 0-59 months of age. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics Committee under the Mongolian Ministry of Health. Results: Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500 grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was slightly higher among girls than boys, however high birth weight was much more common in boys (15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region (9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW rate was more than double among mothers in kazak ethnic groups (13.8%). Conclusions The younger age of the mother was more likely to develop low birth weight, and it was twice as high among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age needed to improve the health education and to identify the causes and risk factors of low birth weight among mothers in Kazak ethnic groups.

Background: Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. Objective: To assess the indicators of infant feeding practices among 0- 23 months old children. Materials and Methods: The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed. Results: 83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households. Conclusions Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.