BACKGROUND: Worldwide, the number of people killed in road traffic accidents (RTA) each year is estimated at over 1.2 million, while the number f injuries reaches as high as 50 million. In Mongolia, the number of road accidents, crimes and road safety violations is on the increase, and it is forecasted that this trend will continue in the future The third leading cause of mortality in Mongolia is injury, and more injuries are caused by traffic accidents (18.9%) than any other cause. According to the National Statistics reports, health and demographic studies, it can be seen that there are a high number of road traffic accidents and injury cases in Mongolia.OBJECTIVE: The main objective was to identify the risk factors of road traffic injuries and deathsMETHOD: Primary data on Road Traffic Accidents (RTAs) of the Road Traffic Police was used. 4000 investigation forms were randomly selected and analyzed. Within the research objectives, necessary descriptive and analytical statistics were calculated and the results were illustrated by tables and charts.RESULT: The rate of road traffic accidents is high in urban areas from January till May while it is high in rural areas from February till October. The rate of road crashes caused by alcohol is significantly different in rural and urban areas (36% in rural and 16% in urban). The statistically significant risk factors for Road Traffic Injuries (RTIs) were the fault of pedestrians, drunk driving, failure to stop the vehicles, turning maneuver, inadequate estimation of the distance between cars and collation of lane and for Road Traffic Deaths (RTDs) the alcohol consumption, speeding, vehicle defects, driver’s negligence, cross the intersection, turning maneuver, failure to keep distance, fault of pedestrians and transportation people or goods.CONCLUSION: To decrease the risk factors of injuries and deaths of RTAs, specific actions are required to enhance the road traffic safety control and patrolling during certain months, weeks, days and times when accidents mostly happen in urban and rural areas.

IntroductionIn Mongolia, cardiovascular diseases (CVDs) and stroke have consistently been the number one cause of population mortality since 1990s. Hypertension is an independent risk factor for CVDs and stroke. There is a conclusive evidence that high salt intake is the strongest dietary factor for hypertension. However, in Mongolia, evidence on actual salt intake of the population, its potential sources and relations to high blood pressure has been in lack so far.GoalThe survey was aimed to determine actual daily salt intake and related behavior patterns in the population residing in Eastern and Khangai regions and in the city and to identify the directions of further activities to decrease the amount of salt consumed per day by the target population.Materials and MethodsThe survey recruited a total of 475 adults from Khentii, Bulgan aimags and Bayanzurkh district of Ulaanbaatar. Questionnaires, physical measurements and laboratory analyses were applied to collect and process the data on population demographics, behavior patterns and salt related KAP, blood pressure and sodium and potassium values in 24 hour urine samples to estimate daily salt intake. A survey database was developed using EPI INFO and the data was entered in twice. SPSS 18 software was used for the data analysis, mean and standard deviations were estimated using t and F statistics on continuous variables with normal distribution, and chi square test was applied to differences in proportions.ResultsMean age of the survey population was 44.5 years; the survey population was not differing in their age, gender and region. Average daily consumption of salt was 9.5 grams in the survey population; it was not differing in terms of region. Men consumed on average 10.1 grams of salt which is twice much higher than the WHO recommended amount. Salt consumption was higher among those aged 45-54 years and rural persons, particularly men. For men and people aged 45-54 years old, the salt consumption was directly related to their salt tea drinking habit (r= 0.14; p=0.04). Those who drink alcoholic drinks frequently have higher body mass index and/or less educational attainment were more likely to drink tea with salt. In the Eastern Region, regardless of a habit of drinking tea without salt, the high salt consumption seems to be caused by insufficient knowledge of salt containing meals and food products (r=.27; p=0.001), lack of awareness of health impacts of salt, as well as lack of attitude towards their control of daily salt intake (r= ; p= ). In the Khangai Region and the urban city, salt added to meals and food preparation (Partial r =.22; p=0.05), salt containing food products and salt tea are the main factors of high salt consumption. The survey population in these areas lacks attitude and practice to decrease and control their daily salt intake.ConclusionSalt consumption is generally high among the adults of the Eastern and Khangai Regions and in UB city; males and rural people are lacking in knowledge and attitude related with salt content of food, food choice and with the potential health impacts of excessive sodium intake.

Background:Bacteriophages act only host bacterial pathogen selectively not affecting the normal microflora of the human digestive tract, not causing allergies. Also found that the bacteriophage preparations don’t have taste, smell and preparation technology doesn’t affect the structure of bacteriophage. Using of bacteriophages for treatment is safe and has established that they are very effective against multi-drug resistant bacteria according to conducted clinical studies. In our country is using the Bacteriophage preparate which is based on local strain of Salmonella Typhi. Nowadays there is no research data whether environmental physical and chemical factors can affect the Bacteriophage activity.Aim:To study whether the environment physical and chemical factors might influence on Bacteriophage of Salmonella Typhi.Materials and Methods:In this study, were used the test strains of the Salmonellatyphimurium, Salmonella typhi and Bacteriophage of Salmonella Typhi. All procedures are performed according to Mongolian National Standard MNS ISO 2416-94, 3317-94 and Bacteriophage of Salmonella Typhi.Our study was established that physical and chemical factors: temperature of water bath, chloroform action time interval, procedure to kept biopreparates all can affect bacteriophage lysis activity.Conclusions:Any use of bacteriophages did not reveal any adverse effects. From the Bacteriophage of Salmonella Typhi preparations kept up to 3 years can be isolated bacteriophage strains by our improved method.

Background: In 1889, keratinocytes conjunctivitis with eruption in the form of Epidemic first was revealed by Fuchs and from 1995 it began to be diagnoses using the polymerase chain reaction. In our country annually about 11,850 patients visited the ophthalmology cabinet of the State Central Clinical Hospital, and from them 1290 cases or 10.89% were diagnosed to have viral infections, including 95% were sick of adenovirus infection, 3.7% had a herpes virus infection, 1,3% infection of other species respectively. At the international level of experience and research on the treatment of adenovirus conducted in a large circle, and immunoglobulin therapy has a high impact (P=0.0001, power 0.7599, ANOVA). In Mongolia, normal immunoglobulin is produced and widely uses to enhance immunity, but technological expertise and experiences on the use of immune globulin in ocular diseases caused by adenovirus infection had not been conducted yet. Goal: To study the possibility to diagnose ocular diseases caused by adenovirus infection with laboratory method and use immunoglobulin in eye area. Methods and materials: The investigation involved 50 patients aged 18-55 diagnosed with the infection of adenovirus. We took samples from eye conjunctiva, blood and stool of patients involved in the investigation and conducted a survey to identify adenovirus using the polymerase chain reaction. In this analysis it was used the diagnosing devise (Amply Sense Adenovirus – Eph) made in Russian Federation. Samples where the virus is detected were multiplied in Hep2 cell culture and viruses were abstracted. Linear cells Hep2 were made culture by methodology and recommendation from World Health Organization. Abstracted viruses were challenged in experimental rabbits by dropping it into their eyes or making injections. After rabbits became completely sick, they were divided into five groups and each had a different treatment. Statistical and analytical software used in the development of research. (SPSS,EPI-info8 STATA). Results: Samples were taken from 50 people and made on them polymerase chain reaction analysis, at 43 (86%) of which were detected adenovirus: Viruses were found in 14(93%) of 15 samples taken from the eye, 12 (80%) of 15 samples taken from the blood, 17(85%) of 20 samples taken from the stool respectively. Sample with viruses was conducted the initial development and made culture in a linear cell Hep 2. Partial anesthesia were made on both eyes of 25 rabbits with use of Proparacaine Hydrochloride and infected them with adenovirus and after 7 days the following treatments were made dividing the rabbits in five groups so that each group has got five rabbits. (Treatment with interferon, ingavirin treatment against viruses, immunoglobulin drops, combined immunoglobulin drops jointly with ingavirin, immunoglobulin injection for combined with ingavirin). After infection eyes of rabbits with adenovirus and descending corneous phlegmon in their eyes, the symptom curing were observed on schedule at 2, 4, 6, 8, 10, 12, and 14th days of each separate treatment group and calculated the average. On the 8th day after starting the treatment combined ingavirin with lg eye drop and treatment lg catarrh injection with ingavirin conducted in related groups, and on the 12th day of treatment with ingavirin, all the symptoms of infections were completely cured. Treatability of group treated with interferon after 14 days was 71 percent. On the basis of the above indicators, we compared the most effective method of treatment with interferon treatment, which is currently in use, then developed a method of statistical significance of the study with indicator ANOVA and proved that the significance of the treatment is of P<0.05. As in the 8th day of the treatment, the symptoms of viral infection is completely eliminated, and at the 10th day is not detected any viruses, we can prove that the treatment of immune globulin effectively prevents the virus and is capable of neutralizing the virus. Conclusions: 1. The experiment shows that intravenous immunoglobulin therapy is an effective method against infection caused by adenovirus. 2. Since immunoglobulin counteracts the adenovirus, it has the opportunity to become a major application against inflammation caused by viruses and bacteria 3. Using of the drug against the virus with a combination of ingavirin has higher effectiveness than the use of only one immunoglobulin against adenovirus.

INNOVATION DENT • VOL. 3 • No.1 • Mar 2017 35 Background Odontogenic infection is defined as most dangerous inflammatory diseases in dental practice, it is believed that the cause of tooth decay disease and its complications currently a major cause of oral infections, or bacterial infection of the main sources of these diseases. Methods Between 2010-2011, odontogenic cellulitis in 21 patients were studied for aerobic and anaerobic bacteria by the Clinic bacterial laboratory in NCCD. Results 21 patients participated, were 10 men and 11 women with odontogenic cellulitis. Aerobic bacteria only were recovered in 3 (14%), anaerobic bacteria were recovered 8 (38%), mixed aerobic and anaerobic bacteria were recovered in 10 (48%). Conclusion A certain percentage of aerobic and anaerobic bacteria in odontogenic cellulitis shows simple space infection caused by aerobic bacteria, other complication of odontogenic cellulitis and multiple spaces infection caused by anaerobic and mixed bacterial infection. During dontogenic cellulitis determined high percentage of anaerobic and mixed bacterial infection, thus is our study have shown detection of anaerobic bacterial infection is important clinical significance in dental practice.

Introduction: The Severe Acute Respiratory Syndrome coronavirus-2 has a major impact in solid organ transplant recipients and the effect of established mRNA based SARS-CoV-2 vaccines have to be evaluated for solid organ transplant patients (SOT) since they are known to have poor responses after vaccination. Method: We investigated the SARSCoV-2 immune response via SARS-CoV-2 S IgG detection in the serum of 17 renal transplant recipients and 11 liver transplant recipients after two doses of the mRNA based SARS-CoV-2 vaccine BNT162b2 following the standart protocol. Result: The median age was 52.5±12 years. Nineteen (67.8%) of the 28 patients were male, and 9 (32.2%) were female. The mean time after organ transplantation was 6.3±5 years (5 months-16 years). The immunosuppressive regimen included mycophenolate (19 of 28; 67.8%), tacrolimus (27 of 28; 96.4%), and corticosteroids (15 of 28; 53.6%).
The antibody response was evaluated once with an anti- SARS-CoV-2-S IgG CLIA (Elecsys Roche, Germany) 30±2 days after the second dose. Only 19 of 28 (67.8%) SOTRs were tested positive for SARS-CoV-2-S IgG after the second dose of vaccine and median titer was 119.5±106.4 Н/мл. Conclusion Thus, the humoral response of SOTRs after two doses of the mRNA based SARS-CoV-2 vaccine BNT162b2 is impaired. Individual vaccination strategies and third dose of vaccine might be beneficial in these vulnerable patients.

Introduction: Health care workers of First Central Hospital of Mongolia have vaccinated with three different vaccines against SARS-CoV-2. We detected SARS-CoV-2 N and S-RBD antibodies after 30-90 days of second dose of vaccination. Method: Quantitation of antibodies to the spike protein of SARS-CoV-2 was performed for the detection of adaptive immune response in 291 HCWs vaccinated with Covishield, Sinopharm and Pfizer Biontech. Detection and quantitation of SARS-CoV-2 N and S antibodies were performed by the electrochemiluminesce assay Cobas e411, Roche. Result: SARS-CoV-2-S-RBD IgG titer were negative 0%, weak positive 0.4%, positive 17.5%, strong positive 82.1% of 246 HCWs vaccinated with Covishield and were negative 2.8%, weak positive 8.5%, positive 57.1%, strong positive 31.4% of 35 HCWs vaccinated with Sinopharm.
In all HCWs vaccinated with Pfizer Biontech SARS-CoV-2-S-RBD IgG titers were strong positive. Conclusion Humoral immunity was produced in HCWs after two doses of Covishield vaccine 100%, Sinopharm 97.0%, Pfizer Biontech 100% respectively. Antibody titer was higher among younger age workers.

Background: Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on long-term graft and patient survival. Objective: Our aim was to assess the long-term graft and patient survival rate correlation with HLA-A-B-DR matching. Methods: We retrospectively analyzed data from 70 adult kidney transplants performed at our hospital from August 2006 through January 2014. The data was retrospectively collected from patient files, including characteristics of the recipient and donor, post transplant features and HLA-A-B-DR DNA based typing results. The Kaplan-Meier method was used to analyze graft and patient survival. Results: The mean patient follow-up period after kidney transplantation was 39,6±25.9 months, and the mean kidney graft follow-up period was 36.6±23.7 months for 70 cases. Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%) respectively in 70 cases. Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%) respectively in 34 cases. The group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (71%; 35%); (80%; 40%) compared to 0 to 1 mismatched group (100%) (p=.030; p=.015). Furthermore we analyzed the association of HLA matching, immunosuppressive therapy and long-term graft survival. We selected CNI mono-therapy group for long-term survival analysis and observed a similar pattern. In mono-therapy group, the group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (75%; 30%); (65%; 30%) compared to 0 to 1 mismatched group (100%) (p=.037; p=.001). Conclusion The results showed that graft and patient survival rates were lower compared with results from established centers. Statistically highly significant effect of HLA matching on kidney graft and patient survival rates was found in our analysis. Five years after transplantation the graft survival rate of first adult kidney transplant with 4-6MM was 65-70% lower than that of grafts with 0-1MM. Longitudinal cohort study needed in the future to exhibit an improved transplantation outcome.

Background: De-novo donor and non-donor specific antibodies could be detrimental to the kidney allograft. Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on post-transplant de-novo antibodies and long-term graft survival. Our aim was to determine immunosuppressive drug through level, its combination, de-novo HLA antibodies and its influence on graft survival in different immunosuppressive protocols. Methods: We analyzed data from 56 adult first kidney transplant recipients at our hospital from August 2006 to May 2013. We determined the level of tacrolimus, cyclosporine A, and the presence of pre and post-transplant anti-HLA antibodies. Results: Post-transplant follow up period was 1-8 years. Mean recipient age on transplantation was 33.9±9.1 years. Male 45 (80.4%). Cadaver donor kidney was 5 (8.9%). Mean donor age on transplantation was 39.98±11.13 years. Rejection occurrence was 12(21.4%). Tacrolimus and cyclosporine A through levels were 3-12.8ng/ml and 65- 324ng/ml respectively. Anti-HLA class I antibodies were detected in 17.9% of pretransplantation (n=10) and in 23.2% of post-transplantation (n=13) cases respectively (p=0.607). On the other hand, anti-HLA class II antibodies were detected in 5.4% of pretransplantation (n=3) and in 33.9% of post-transplantation (n=19) cases (p=0,001). We determined anti-HLA class II antibody specificity. Anti-DQ, DR, DP antibodies were 25% ( n=14), 14.3% ( n=8) and 7.1% ( n=4) respectively on all 56 cases. Two (3.6%) patients’ samples were positive on three loci of HLA class II. Six patient samples (10.7%) were positive on two loci. Nine (64.3%) of anti-DQ positive patients have rejected their grafts and begun hemodialysis treatment. All 9 graft rejected recipients were anti-HLA DQ positive and had taken cyclosporine mono-therapy for the first year after transplantation. Conclusion The presence of de-novo anti-HLA class II antibodies, especially de-novo anti-DQ were significantly increased on cyclosporine mono-therapy group following transplantation and negatively affected kidney graft survival. The blood through level of cyclosporine was very variable. The graft survival was better in standard triple regimen. Therefore, it is essential to monitor immunosuppressive drug combinations with drug blood level and anti-DSA antibodies as well as to manage antibody removal therapies such as therapeutic plasma exchange, intravenous immunoglobulin and Rituximab therapy on time. HLA –DQ-DP antigen determination is important for the kidney transplantation.

Introduction: Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection. Materials and Methods : The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis. Results: Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July.
Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05). Conclusions Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.