Introduction. Cervical cancer is one of the most common cancers among women worldwide. Its mortality exemplifies health inequity, as its rates are higher in low & middle income countries (LMICs ), and in low socio-economic groups within countries. Around 80% of global cervical cancer cases are in LMICs. (WHO, 2008 ) Goal. To determine the prevalence, incidence and mortality for cervical cancer among Mongolian population Objectives: 1. To determine the trends of incidence and mortality for cervical cancer by regions among Mongolian population during 2000-2009 2. To estimate DALYs for cervical cancer in 2009 Materials and Methods: Data for this study were abstracted from Annual Reports of the National Cancer Registry for 2000-2009.I ncidence and mortality rates were calculated as mean annual numbers per 100,000 residents. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) were calculated by the direct method by weighting age-specific incidence and mortality rates to the World Population. The DALY combines in one measure the time lived with disability and the time lost due to premature mortality: DALY = YLL + YLD YLL – years of life lost due to premature mortality YLD – years lived with disability. Results: last ten years, the trends have been increasing of the prevalence, incidence and mortality rate for cervical cancer in Mongolia. The cervical cancer incidence rates are the highest in Central and Eastern regions than other regions. The average burden of cervical cancer across all regions in 2009 was 2868 DALYs per 100000 population, of which about 30,9% was due to premature death and 69% non-fatal health outcomes. Conclusion: The incidence of cervical cancer is generally low in China, moderate in Japan and somewhat higher in Korea and Mongolia [11]. Need to estimate the DALYs for common cancers in Mongolia.

The results of studies on heavy metal and bacterial contamination in Ulaanbaatar since 1990 have beensummed up in this abstract. In the recent years, soil pollution has increased due to rising number ofpopulation, especially in ger districts, factories and services in Ulaanbaatar. According to some surveys,pollution indicators of lead, arsenic and bacterial contamination in soil have exceedednationalstandardlevel.

The genus Iris belongs to the family Iridaceae and comprises of over 300 species and fifteen species of genus Iris are found in Mongolia. Iris has long history of use in various indigenous systems of medicine as alternative aperients, stimulant, cathartic, diuretic, gall bladder diseases, liver complaints, dropsy, purification of blood, venereal infections, fever and bilious infections and for a variety of heart diseases. Rhizomes of Iris are rich source of secondary metabolites and most of these metabolites are reported to possess anticancer, antiplasmodial, anticholinesterase, enzyme inhibitor and immunomodulatory properties. Approximately more than two hundred compounds have been reported from the genus Iris, which includes flavones, isoflavones, glycocides, benzoquinones, triterpinoids, stilbene glycosides and organic acids. In this article, we reviewed the published results of phytochemical and pharmacological studies of some Iris species which are grown in Mongolia.

The DPLDs are important, accounting for about 15% of respiratory practice. They comprise a very wide spectrum of pathologies, presentations, and outcomes. There is a serious paucity of evidence about the management of DPLDs, but the morbidity of the DPLDs themselves and the treatments available may be high, with potentially serious consequences therefore for mismanagement. There is concern that DPLDs may be poorly recognized and managed by nonspecialists. Respiratory specialists are the only group with appropriate training and skills to deal with the complexity of the diagnosis and management of these conditions. British Thoracic Society (BTS) Standards of Care Committee set up a sub-committee to formulate recommendations on DPLD management. Purpose of the recommendations: to support improved recognition, diagnosis, assessment, and treatment of patients with DPLD, to raise awareness of the importance of DPLDs, to provide an authoritative current literature review of DPLDs management, to provide practical, evidence and consensus based recommendations that will aid the development of clinical services for patients with DPLD. This article contains the summary of diagnosis and assessment of diffuse parenchymal lung disease, based on BTS recommendations on DPLD management.

BACKGROUND: The Western Australian Family Study of Schizophrenia (WAFSS) has conducted genetic epidemiology studies of schizophrenia in Australia for two decades. Recently the WAFSS practices were adopted at the National Centre for for Mental Health in Mongolia, with a view tocollecting comparable data. Like the cited projects (supra), we are cognizant of the dangers of multi site data collection. We replicate common practices, such as training manuals and common site training and refreshment (CCRN WHO training centre). However in international (possibly multilingual) collection and pooling, identical assessment is difficult, it is impossible to replicate endophenotype instructions verbatim (Calkins 2007), and identical recording equipment may not be available indisparate sites. At the very least the data must be compared separately, with the option of weighting,before the pooling for genetic analysis. The use of endophenotypes (Gottesman& Gould) is well established in schizophrenia research for genetic analysis () as well as in more general neuroscience biomarker approaches. The use of electrophysiological markers, and particularly Event-Related Potentials (ERPs) is a well developedaspect of this approach (BraffDL, 2007, TuretskyBI, 2009). Electrophysiological endophenotypes include (inter alia) the Mismatch Negativity (MMN), P50 suppression ratio (P50), auditory oddball P300 (P300), and Antisaccade (AS) tasks. In this study, we seek to follow the multi centre quality assurance examples for pooled data on a smallerscale. This report details the validation of compatibility between the Western Australian Family Study of Schizophrenia (WAFSS) dataset (Perth, Australia), and a pilot dataset from the National Centre for Mental Health (NCMH) in Ulaanbaatar, Mongolia. The working hypothesis is that the psychiatric and endophenotype profiles in the two datasets are sufficiently similar to allow data ompatibility for genetic analysis.METHODS: The Mongolian version of the DIP was developed as part of a joint genetic investigation of schizophrenia between the Centre for Clinical Research in europsychiatry (CCRN) in Perth Western Australia, and the National Center of Mental Health (NCMH) in Ulaanbaatar, Mongolia.The DIP is a semi-structured interview for psychosis for use in epidemiological and clinical settings (CastleD, 2006). It is designed to provide a diagnosis, as well as to assess symptom profiles (present state, past year and lifetime), social functioning, disablement, and service utilisation. It was developed specifically for the National Mental Health Survey – Low Prevalence (Psychotic) Disorders Study(Jablensky et al, 1999, 2000), and has been translated to Italian (RossiA, 2010), Norwegion (SkorvenCS, 2010), and to Mongolian in 2012. The process started with the translation of the original English language version (Castle et al., 2006) by an experienced bilingual psychiatrist (GE) from the NCMH whose native language was Mongolian. Layout and formatting of the document were preserved. It was then back-translated by a non medical,tertiary educated professional, whose native language is Mongolian, but is now resident in Perth. The back-translation was reviewed by an original author (AJ) and experienced practitioners (GP). Grammatical and syntactical discrepancies were resolved directly with the original translator. Event Related Potentials To replicate the WAFSS ERP approach at NCMH, a new portable ERP recording system was deployed. This decision was based on several considerations: a) the WAFSS system could not be taken out of service; b) an identical system could not be replicated due to the age of the components; c) an equivalent system would be too substantial for easy, cost effective transport; d) the system was expected to be used in multiple sites in Mongolia; e) the same system was expected to be used in other Australian projects.The Portable ERP system uses NuAmps, with a hardware selected reference at the FPz location. While the ear references A1 and A2 were recorded, the mathematically re-referenced data is not the same as directly linking ears. (Citation ****). Instead the data was analysed as recorded, with cognizance traces (instead of 20) could not be used. This marks a variation from the original WAFSS processing. Instead of artifact rejection on any trace, only the relevant trace (Fz, Cz, Pz) was used for each ERP (MMN, P50, P300). Endophenotypes The ERP endophenotypes are clearly continous variables, and analysed with general linear modelling. Two tailed significance testing was used for between cohort comparisons, since there is no a priori indication which cohort would have the higher values. Single tailed testing was used in comparing Proband (Pb) and Control (Ctl) groups within the same cohort, as thedirection of any difference is well established.RESULTS: DIP The structure of the diagnostic module (DIP-DM) follows the Operational Criteria for Psychosis, OPCRIT, version 3.31 (McGuffin et al., 1991; Williams et al., 1996) 90-item checklist. It can be used to generate diagnoses according to the criteria of ICD-10 (World Health Organization, 1993); DSM-IV (American Psychiatric Association, 1994); the Research Diagnostic Criteria (Spitzer et al., 1978), and others. The summary of diagnoses (ICD-10 and DSM-IV) generated for each cohort are shown in Figure 1. Diagnostic distribution (%) of 30 interviewed cases from NCMH and 201 cases from the WAFSS cohorts, according to the DIP diagnostic algorithm, by diagnostic classification system. To facilitate omparisons between different criteria systems, Castle (2006) escribes aggregated diagnostic classification descriptors (with reservations) that are used in Figure 1. Greater detail of the DIP responses that support these descriptors is shown for similiarly aggregated questions in Figure 2. aMicrovolts for MMNAmp and P300Amp, numeric forothers.bFor MMN, P50, and AS, but not P300, the raw mean (notabsolute value) for the Pb and Fm groups are higher thanthat of the Ctl group. cEqual variances not assumed.Endophenotype values were each significantly “worse” inthe proband group of the NCMH cohort, for MMN (t=1.65;p=0.05), P300 (t=-2.02; p=0.02) and AS (t=2.12; p=0.02).The comparable values from the WAFSS cohort showed thesame behaviour for MMN (t=4.52; p<0.01), P300 (t=-3.35;p<0.01) and AS (t=3.93; p<0.01). The P50 endophenotypedid not show a significant difference between clinical groups in either NCMH (t=0.20) or WAFSS (t=1.12) cohort. DISCUSSION: This comparison has shown that there is not a significant difference (α= 0.05) between the NCMH and WAFSSpopulations (patient and control). This outcome is deemed sufficient to allow pooled analysis of genetic and electrophysiological data in future studies. It is acknowledged that the outcome does not show that the two populations are the same. Questions of international comparison (McGrathJJ, 2006) in incidence and prevalence, of mental illness and particularly of schizophrenia are eschewed. These were not the purpose of the study. Our experience from this study, as distinct from analysis, is that situational variation in equipment, protocol and recruitment likely outweigh any cultural differencesin epidemiology. The absolute value of the lectrophysiologicalendophenotypes was different between the two sites, butthe relative values were the same. The control group showed“better” responses than the patient group, with similareffect size. Moreover, the patient clinical profile was also slightly different. The incidence of neuroleptic medication was a substantial uncontrolled factor. The question becomes how to deal with these differences.In combining population groups, the data can be discarded,equalized, or transformed. Describe each. We seek to standardize comparisons between populations by transforming data by scaling prior to genetic analysis.Absolute value The raw amplitude data for both ERP eatures (MMN, P300) is significantly lower from the Mongolian cohort in both Patient and Control groups. Endophenotype characteristics.ScalingWhile the difference in absolute values precludes directlycombining data from different cohorts, the consistentendophenotype characteristics allows one possiblemethod to further genetic investigation of continuousendophenotype variables. The results are expected toderive from a combination of technical, situational, clinicaland endophenotype factors. Each of these factors could befurther investigated individually. However, if a combinedendophenotype analysis is even theoretically acceptable,then the endophenotypebehaviour in different cohorts hasto be defined as identical, and the standardized measuresfrom equivalent Control groups must be equal. If the WAFSScontrol group is considered as the standard in this study, then the scaling factors for the NCMH cohort are 13.5 (MMN), 1.0 (P50), 2.5 (P300) and 0.6 (AS).SUMMARY: The consistency in endophenotypebehaviour betweencohorts legitimizes the application of the genetic approachin Mongolia. DNA extraction and analysis for this cohort iscontinuing and, although for smaller numbers, preliminaryresults can be compared with the Australian cohort.

INTRODUCTION: Urinary tract infections among the most common bacterial infectious diseases encountered at all ages. Escherichia coli are being the etiologic agent in 50–80%. Therefore, it is an important public health problem. E.coli causing urinary tract infections express pilli, fimbriae and others adherence virulence factors. GOAL: To detect the some adherence virulence factors of Uropathogenic Escherichia coli (UPEC) in Ulaanbaatar, Mongolia MATERIALS AND METHODS: A total of 76E.colisampleswere collected. These samples were positive bacteriological examination of urine, performed at the bacteriological laboratory of the State Central Third Hospital and State Central First Hospital, Ulaanbaatar, Mongolia. The biofilm formation was evaluated by the growth rate of E.coli on plastic surface.The detection of the virulence factors type 1 fimbriae (fimA gene) and P-fimbriae (papC) was performed by multiplex PCR using gene specific primers.Curli expression was determined by using congo red agar. RESULTS: The evaluation of bacterial biofilm formation using 96 well plates showed 40 negative (52.6%), 32 weak biofilm (42.1%) and 4 moderate biofilm (5.3%) formation for E.coli and no strong biofilm forming strain was detected. The cell surface protein (curli) was detected by Congo red agar. The result was 71% positive for studied E.coli strains. The detection result of pili genes by multiplex PCR showed that fimH gene detected for 73 (96.1%) and papC gene detected for 18 (23.7%) E.coli cultures. CONCLUSION: Almost half of surveyed Uropathogenic E.coli isolated in Ulaanbaatar, Mongolia had ability of biofilm formation and it has been determined by the bacterial surface protein (curli), which is one of bacterial adherence factors, may cause biofilm formation.

Introduction: An international study coordinated by the International Agency for Research on Cancer (IARC) and published today in The Lancet Oncology shows that in 2001–2010, childhood cancer was 13% more common than in the 1980s, reaching an annual incidence rate of 140 per million children aged 0–14 years worldwide. Cancer incidence and mortality statistics reported by International Cancer Research Center (2016), over 300,000 children develop cancer worldwide each year, 215000 children aged 0-14 years and 85000 children aged 15-19 years. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. Based on the need for comparison of childhood cancer incidence in Mongolia to the global level, the study aimed to categorize cancer among children aged 0-19 years. Goal: To study the insidence rates and trend from childhood cancer last 10 year in Mongolia Materials and Methods: The study was conducted in 786 new cases childhood who were cancer diagnosed, between 2008 and 2017 year. Age-standardized incidence rates were calculated by the direct method using age-specific incidence rates and weights based on the age distribution of the standard world population Results: Over the past 10 years, childhood cancer accounted for 1.5% of total cancer in Mongolia. By WHO and IARC data, worldwide childhood cancer age standardized rate (ASR) is 106.0, in Mongolia childhood cancer ASR (101.6) is lower than world average. The most common childhood cancers worldwide are: 1st leukemia, 2nd lymphoma, 3rd central nervous system cancer, 4th retinoblastoma, 5th soft tissue cancer. Over the past 10 years the most common childhood cancers in Mongolia are: 1st leukemia, 2nd central nervous system cancer, 3rd joint bone cancer, 4th lymphoma, 5th soft tissue cancer. Our country’s childhood cancer ASR is below compared to other countries, but expected growth rate is gradually increasing (3.0 per year). Conclusions
1. Leukemia is the most common childhood cancer in worldwide and also in Mongolia.
2. By sex, childhood cancer incidence is higher in boys than girls.
3. By age group, childhood cancer incidence is the highest in 0-4 age group.
4. By region, childhood cancer incidence is the highest in central region.
5. The overall incidence of childhood cancer (1 million children) in Mongolia is expected to increase by 3.0 over the next 5 years.

NEED FOR STUDY AND GOAL: There is no data available on pupil’s health with relation to the school environmental condition and organization of educational activities in Mongolia. Therefore, the goal of the study was to assess organization of the educational activities and conduct hygienic assessment of chemical and bacteriological contamination in the school environment.MATERIALS AND METHODS: A total of 1440 children were surveyed in this cross sectional study from the 6 secondary schools of UB city, Uvurhangai and Dornod aimags.Hygiene conditions of school was assessed and organization of educational activities evaluated by class timetable and pupil’s notes of daily regime.RESULT: Timetable of lessons: It was observed that in some cases teachers’ taught to primary pupils Mathematics and Mongolian language for 2 sequential hours, depending on some indexes such as lesson content, capacity and student’s activity. According to timetable of lessons of the secondary schools, pupils have lessons for 32-34 hours in a week. It was revealed that most schools have 2-3 hours more than standard timetable and heavy lessons were taught for 2-3 sequential hours. For the secondary classes, average length of classes was 32-34 hours in a week which indicates 2-3 hours longer timetable. There was no special place for physical training and movement games etc where pupil can do physical exercise, relax and enjoy school life. DAILY REGIME: pupils have been spending most of their time watching TV and listening music and spending few hours to help housework, to read a book and to prepare meal. Urban pupils spent total of 0.5-1 hour for coming to school and going to home but rural pupils spent 20-30 minutes approximately. RESULT OF THE LABORATORY ANALYSIS: The bacteriological analysis of 36 classes in schools showed that before lesson, 94.4% of classes were clean while 5.6% was contaminated in first season of school year. After the lesson, percentage of classes without contamination had been dropped to 88.8% and classes with contamination had been increased to 11.2%. In the 4th season of school year, before lesson 61.6% of classes was clean and 16.6% was contaminated and 22.3% was highly contaminated. Moreover, after the lesson, classes without contamination had been dropped to 27.7% while 72.3% was at high level contamination.CONCLUSION: 1. Time table of lessons and break time management is inadequate in the schools and 32-39.1% of pupils do not follow the daily regime. 2. In the end of day, chemical and bacteriological contamination increased in the classes.

INTRODUSTION: There have been limited research studies done in Mongolia on health status of children in relation to density of children in school classrooms.GOAL: This study aims to evaluate learning ability of children in Mongolia and develop recommendations for next intervention measures.MATERIALS AN METHODS: A total of 1440 children were surveyed in a cross sectional study that included 6 classes from 6 secondary schools of UB city, Uvurhangai and Dornod aimags. The test of letter drawing created by of V.Ya.Anfi mova was used to evaluate the pupil’s learning skills. This test was performed at the fi rst and last classes in each day of which was tested at the beginning (I quarter or September) and end (IV quarter or May) of the academic year.For each tests we accounted the mean of drawing letter, mean of mistake for 500 letter and standard deviation.RESULTS: The results of pupil’s letter drawing tests were compared by quarter for fi rst and last classes in each day. Pupil’s learning ability of class 4 was enough while other classes were not enough (P index 1) on the fi rst and last tests.CONCLUSION: Pupil’s learning ability has been changed by the same way of physiological adaptation process of child.Pupil’s learning ability had been decreased in last tests of each day and on Friday which was revealed by letter drawing test.Pupil’s learning ability of classes between 4 to 9 were not enough on the fi rst term while 4th class was good enough on the forth term (P index 1).

GoalTo evaluate the quality, results, and processing of cytology analyses of early detection program ofuterine cervical cancer implemented in Mongolia, which based on Pap test, at Ulaanbaatar city level.Materials and MethodsInformation was collected from the databases of the recalling system of screening program of theCancer registration and information unit of the NCC of Mongolia and districts pathology laboratoreis.Statistical significant level of 1.96 (95% CI) andthe margins of error 0.05 were considered andsample size was calculated by using the information that 10% of unsatisfied results appear onquality assurance of international level. Thus calculations were madefortotal of 1723 (585 positiveand negative 1138) samples, by collecting 287smears from each district.At the district level all the selected slides were reviewed blindly and compared to the previouscytological conclusion. Diagnostic validity was defined by calculating parameters such as specificityand sensitivity, positive and negative predicted values. The Kappa index criteriais used for statisticalcalculation of the cytological diagnosis conclusion matches.ResultsThe target group women coverage of cervical cancer screening program is 40.8%. Out of all positiveresults of early screening cytology, 77% were at an early stage and 23% were at an advanced stage.Thus positive signs were showed with increased detection results in early stage of uterine cervicalcancer (P = 0.05). Positive results of Pap test were follows; ASCUS (53.2%), ASC-H (10.0%), LSIL(19.2%), HSIL (13.4%), CIS (3.4%), and SCC (0, 8%). Out of total slides, 86.7% were as satisfactory.The test results conducted at the district level were90.1% of sensitivity, 88.8% of specificity and9.9% of false negative response. The discrepancy of results of cytology test in districts and repeatedseen is 31.4% (K = 0.749; p = 0.001).ConclusionThe coverage of cervical cancer screening program that has been implementing in our country isnot enough. There are problems at the district level including severe damages of uterine cervix andincomplete diagnosis. The quality of the cytology test is relatively unsatisfied.