INTRODUCTION:GSTs are a family of antioxidant enzymes that responsible for the detoxification of many carcinogens.Glutathione S-transferases are polymorphic in humans and the null genotypes are results in lack ofenzyme activity.In many studies the polymorphisms of GSTM1, GSTT1 have been associated withcancers of the lung, bladder, breast and colon.GOAL:In this research we aimed to establish PCR condition for obtaining “long” PCR product for detectionof deletions in GSTT1, GSTM1 genes using various master mixes, which would help us further todetect heterozygous variants for these two genes in Mongolian population.MATERIALS AND METHODS:Three kinds of commercial master mixes as Go Taq PCR master mix (USA), Taq 2x Dual master mix(Mongolia), and DyNAzyme EXT buffer were tested at various PCR conditions on 117 DNA samples,isolated in three ways such as phenol chloroform extraction method, guanidine hydrochloride methodand using Promega Wizard Genomic Fragment DNA Extraction Kit from fresh blood lymphocytes,buccal swabs and dried blood spots.RESULTS:Three types of samples were used for DNA extraction such as buccal swabs, dried onto soft tissueblood spots and fresh peripheral blood lymphocytes, using three kind extraction methods from whichDNA template obtained from fresh blood isolated by guanidine chloride method had best quality.Combination as template DNA from fresh blood, guanidine chloride DNA extraction method and Taq2x Dual master mix (Mongolia) resulted in all four band, whereas other combination did not displaydesired results.CONCLUSIONS:Out of three kinds commercial master mixes tested in this study for various PCR templateDNApreparation and PCR conditions we observed that:1. PCR with Taq 2x Dual master mix (Mongolia) resulted in all four initially desiredPCR productsas 625bp for GSTM1, 969bp for GSTT1 genes and 4748bp for GSTM1, 3106bp for GSTT1 genedeletions correspondingly;2. Template genome DNA prepared from fresh peripheral blood lymphocytes by guanidinehydrochloride extraction methods suited best for “long” PCR reaction;3. Using Taq 2x Dual master mix produced in Mongolia saved us time and was cheaper.4. Multplex primer mix is excellent tool in research of GST gene polymorphism.

IntroductionGSTs are a family of antioxidant enzymes that responsible for the detoxification of many carcinogens.Glutathione S-transferases are polymorphic in humans and the null genotypes are results in lack ofenzyme activity. In many studies the polymorphisms of GSTM1, GSTT1 have been associated withcancers of the lung, bladder, breast and colon.GoalIn this research we aimed to establish PCR condition for obtaining “long” PCR product for detection ofdeletions in GSTT1, GSTM1 genes using various master mixes, which would help us further to detectheterozygous variants for these two genes in Mongolian population.Materials and MethodsThree kinds of commercial master mixes as Go Taq PCR master mix (USA), Taq 2x Dual master mix(Mongolia), and DyNAzyme EXT buffer were tested at various PCR conditions on 117 DNA samples,isolated in three ways such as phenol chloroform extraction method, guanidine hydrochloride methodand using Promega Wizard Genomic Fragment DNA Extraction Kit from fresh blood lymphocytes, buccalswabs and dried blood spots.Results:Three types of samples were used for DNA extraction such as buccal swabs, dried onto soft tissue bloodspots and fresh peripheral blood lymphocytes, using three kind extraction methods from which DNAtemplate obtained from fresh blood isolated by guanidine chloride method had best quality. Combinationas template DNA from fresh blood, guanidine chloride DNA extraction method and Taq 2x Dual mastermix (Mongolia) resulted in all four band, whereas other combination did not display desired results.Conclusions:Out of three kinds commercial master mixes tested in this study for various PCR template DNApreparation and PCR conditions we observed that:1. PCR with Taq 2x Dual master mix (Mongolia) resulted in all four initially desired PCR productsas 625bp for GSTM1, 969bp for GSTT1 genes and 4748bp for GSTM1, 3106bp for GSTT1 genedeletions correspondingly;2. Template genome DNA prepared from fresh peripheral blood lymphocytes by guanidine hydrochlorideextraction methods suited best for “long” PCR reaction;3. Using Taq 2x Dual master mix produced in Mongolia saved us time and was cheaper.4. Multplex primer mix is excellent tool in research of GST gene polymorphism.

Background: Blood is an important resource, both for planned treatments and urgent interventions. It can help patients suffering from life-threatening conditions live longer and with a higher quality of life, and supports complex medical and surgical procedures. According to WHO recommendation at least 1% of the population of any country needs to donate their blood to accommodate the basic clinical needs of the country. Accordingly, we aimed to assess existing attitudes of the general population towards on blood donors. Materials and Methods: The survey identified attitude of the population on blood donation and factors influencing them, using quantitative and qualitative methods. The survey covered a population aged 18-60 years. SPSS software version 21 was used for data analysis of the survey. The survey protocol and methodology were reviewed and approved by the Scientific Committee at the NCPH. The Medical Ethical Committee at the MOH reviewed the survey materials and issued an approval (2015/3). Results: The survey covered in total 3,782 people and there are 59.2% of surveyed respondents said they have never thought of becoming a voluntary blood donor. Positive attitude on blood donation is higher with statistical significance among women (59.0%), 18-25 years old (43.7%) and UB residents citizens with higher education. As education level increases the number of respondents who thought about donating blood is also increases. 16.1% of them had a history of blood donation before and 38.2% said they never thought about it. Twenty point four percent of respondents thought blood donation brings some kind of risk. Nevertheless of the education level of surveyed respondents, the percentage of answer blood donation is not risky for a person was the most common answer. But respondent who is only literal and uneducated were don’t know about whether it has a risk or not (385.37=2א, p=0.000001). Also, respondents failed to donate their blood because the family not allowed, afraid, risk of infection, doesn’t want and had a busy schedule. Conclusion There is a high tendency to donate blood populations of young people aged 20-29, women, residents of Ulaanbaatar, and uneducated and highly educated. The majority of respondents agreed that blood donating is charity and a good deed. The leading causes of blood donation is the education, gender, the desire of doing a good deed, peer influence and health condition.

BackgroundClimate change, as defined by the United Nations Convention on Climate Change, is a “Change of climate which is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and is observed over time”. In 2001 an Initial Communication on Climate Change was prepared by the Government as part of its obligations under the UNFCCC. One of its recommendations was for “creating public awareness among a wide range of stakeholders including public, private and community sector organizations”. GoalThe main goal of the study was to develop recommendations and measures on prevention from diseases and adaptation to climate change by assessing knowledge, attitude and practice (KAP) of population towards climate change. Based on the main goal the following objectives were setup. Therefore addressing the different levels of knowledge and types of attitudes and practices people have towards climate change must initially be dealt with at the local level where site specific variations can be accounted for. Once research has been undertaken at the local level it can later inform decisions and policy at the regional, continental and global levels on how to incorporate site specific variations with in the greater context of the global threat.Objectives:1. To determine knowledge and attitude of population towards climate change;2. To determine practice of population on some adverse consequences of climate change;3. To develop recommendations and measures on prevention from and adaptation to climate change;Materials and MethodsThe study was at once carried out by means of questionnaire. In order to assess KAP of population, the data was collected using a card with 38 questions in three chapters which previously produced and ratified. The questionnaire was structured into 4 sections; demographics, knowledge, attitudes and practices. Two sums in an aimag from each climate zone of Mongolia were selected. In total, 2258 respondents aged 15 to 64 were involved from eight sums in four aimags (Zavkhan, Selenge, Dornod and Umnugovi), and two districts in Ulaanbaatar. The study data was input to computer using EPIDATA-3.6 software and statistically analyzed using SPSS-18.0 software.ResultsA total of 2258 individuals were interviewed. 44.1% 44.1% (995) of the participants was residents of Ulaanbaatar city and remained percentages accounted for residents living in the center of aimags and soums. 56.7% (1281) of participants were women and 43.3% (977) were men aged with 35.2±15.1 in average. Most of the study participants had educated with medium level (34.8%) and high level (30.0%). Employment percentage is 47.5% (1073). However, most respondents interpreted the meaning of climate change as “a change in weather,” “a change in normal climate conditions,” or “a change in temperature” – answers that requires more common sense than climate change savvy. Global warming is one of the evident of climate change. To know study participants awareness about climate change we used terminology of global warming. 25.3% (571) of the total participants answered that climate change revealed by the overheating or warming earth surface. 42.4% of the respondents answered the climate change could affect to health, 33.2% to environment and 16.3% to economy. 84.5% (1908) of the study participants agreed with that climate change has been started. Most of them (71.3%, 1824) allowed that people’s improper use of nature tend to global warming. When ranging the protection practices during the strong storm means of timbering the houses or gers accounted for 42.5% (960). Study participants supported the following activities; 41.2% (931) agreed that is it necessary to increase health services and 34.1% (769) suggested that it is better to enhance training and propagation for increasing awareness of population about climate change adaptation procedures and some information on climate changes and protection events. 85.2% (1923) of the study participants answered that they want to get the information on climate change from public TV.ConclusionsAlthough knowledge on global warming as the climate change was poor among the respondents, they agreed the climate change has already been started worldwide as well as in Mongolia. Only half of the respondents have had practice to prevent themselves from natural disaster.

INTRODUCTION:In connection with request and financial assistance of Swiss Development Agency ‘’Mercury exposureand health impact assessment study among small scale miners in mercury free technology, wasconducted by researchers of Toxicology division of NCPH.GOAL:To determine mercury exposure level in biological samples of local small scale miners from mercury freetechnology introduced area. To reveal chronic mercury intoxicated patients,MATERIALS AND METHODS:Totally 147 artisanal miners from 33 cooperatives for small scale mining from Bayan-Îvoo soum ofBayankhongor, Bornuur sum of Tuv, Bayangol, Mandal and Tunkhel sum of Selenge province areparticipated in this study and the study was performed by cross sectional study methods during April toDecember, 2014.Over all 147 participants were in the first part of study, 60.5% out of 147 (89 participants) were in secondparts, and another 35.4% (52 people) were participated to the third parts of study. The participants wereundergone in to toxicological, dermatological and neurological examinations and the WHO guidance formercury exposure determination was followed in this study.RESULTS:On the results of all testing we revealed that there were 2 cases of chronic mercury intoxicated patientsfrom each Bayangol Bornuur soum, 2 from Mandal soum, and 3 from Bayanovoo soum.Overall 7 patientswere diagnosed as chronic mercury intoxicated and it comprised 4.7%of (n=147) all involved participants.We have observed that average height of total medical examination number was (2.9) in Bornuur soum.It indicated that there will have higher number of patients would exist in Bornuur soum than others.Ourstudy result has shown that neurological symptoms like tremor and imbalance were more diagnosedamong participants from Mandal and Bayngol soums. It implies that the health of the small scale minersfrom this soum more affected and needed to be investigating further.CONCLUSIONS:Mercury is still being used among artisanal gold miners even thoughit is still illegal. Further medicalevaluation and assistance needed to be taken for newly diagnosed 7 patients.

Background: A blood product is any therapeutic substance derived from human blood, including whole blood and other blood components for transfusion, and plasma-derived medicinal products. Medicinal (medical therapeutic) products derived from human donations of blood and plasma play a critical role in health care. Safe, effective and quality-assured blood products contribute to improving and saving millions of lives every year, as they: address child mortality and maternal health, dramatically improve the life expectancy and quality of life of patients suffering from life-threatening inherited disorders, such as haemophilia, thalassaemia and immune deficiency, and acquired conditions such as cancer and traumatic haemorrhage and support complex medical and surgical procedures, including transplantation. An insufficient or unsafe blood supply for transfusion has a negative impact on the effectiveness of key health services and programmes to provide appropriate patient care in numerous acute and chronic conditions. Ensuring access of all patients who require transfusion to safe, effective and quality-assured blood products is a key component of an effective health system and vital for patient safety.
Although the number of blood donors is increasing, there are still insufficient human and financial resources for encouraging the growing demand of blood and blood products and new blood donors. Material and Methods: We collected secondary data by using using the order forms of hospitals that used blood and blood products registered in the National Center for Blood Transfusion Research in 2017-2019 in accordance with the retrospective survey method.
In total 34,119 hospital order information sheet was entered into computer in excel program, and converted into SPSS 23 software, descriptive parameters were calculated and analyzed. Results: Compare to the 2017 (n=9076), the demand of blood product was increased by 21.8%, and 54.8% in 2019. There are 51.9% (95%CI: 51.2-52.5) of total users are male, which is statistically significant. The mean age of blood product users were aged 48.58±21.32, the youngest user was aged 1 and the oldest age was 99. The demand of blood products were increased by growing of the age of users. The product usage of age group of 46-55 was 17.8% and has trend to increase year by year. In total, 11.3% of total blood product was utilized for children and 72.3% of them were aged less than 5 years old. 73.0% of total blood products were utilized in specialized hospitals, 14.6 % of them were used in aimag and district level hospitals and 11.3% of them were used in private clinics. 24.4% of blood products utilization was used for diseases of digestive system (К00-К93), 22.1% of them were used for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, and 19.5% of them were used for the cancer (C00-C97) disease patient’s treatment. Conclusion Since after new treatment guidance was introduced the blood and blood products usage had been increased.

Introduction: During this pandemic, overcrowding in classroom caused by a lack of educational facilities and poor indoor air quality are the main causes of respiratory diseases among children and adolescents. Therefore, it is essential to measure and assess the indoor air quality where children spend extended periods of time such as school. Materials and methods: This study covered four schools with old buildings and four schools with new buildings in Bayanzurkh, Sukhbaatar, Khan-Uul, Chingeltei district of Ulaanbaatar. We collected PM10 and PM2.5, carbon dioxide, air temperature, humidity, and microbiological count from chosen classrooms and compared to the MNS4585:2016 standard. SPSS-24 was used to do statistical analysis on the information gathered during the evaluation. Results and Discussion: The 24-hour average PM2.5 concentration was 64.3 (95% CI: 64.1-64.5) mcg/m3, which was 4.3 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016 standard. The 24-hour average PM10 concentration was 85.3 (95 % CI: 85.1-85.6) mcg/m3, which is 1.9 times higher than WHO guideline value. In older school buildings, the 24-hour average PM2.5 concentration was 5.6 times higher than the WHO guideline value and 1.7 times higher than the MNS4585:2016; the average PM10 concentration was 2.8 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016. The air temperature and carbon dioxide concentration in classroom was met the MNS4585: 2016. The average relative humidity of all schools is 24.2±6.5%, which is 14-16% lower than the MNS4585: 2016. Conclusion The indoor air quality of the school in new and old buildings was similar poor, therefore a variety of steps are needed to improve it.

Introduction: Sanitation facility supply and service availability of Mongolia is essential due to the slow process of bacterial decomposition which is getting significant difficulties because of the cold and arid climate. Only 37 percent of Ulaanbaatar’s population is connected to the central sewerage system, and the majority of ger area residents, or 95 percent, use pit latrines in demand of sanitation facility. Numerous studies have shown that the main contaminant of the soil in ger area were pit latrines. It not only pollutes the environment but also affects human health. There is a lack of awareness about the transmission of infectious diseases and options of new sanitation facilities and poor knowledge and bad conditions to introduce new drainage systems. Most pit latrines in ger areas are of poor quality and do not meet relevant standards. Goal: To determine the effect of ”Gipon” ionized disinfectant solution produced by Japanese technology for disinfecting pit latrines Material and Methods: This study was conducted in December 2019 using a random sampling method. Five households in ger areas were selected and pit latrines were disinfected by ”Gipon” ionized disinfectant solution. Results: The survey covered pit latrines of 5 households in the 21st khoroo of Bayanzurkh district. All owners allowed to participate in the survey. The pit latrines are located approximately 9.8 meters away from the households participated in survey. They have been utilized it for 7.6 years and used by an average of 6 people per day. For inner cover, 60.0 percent are lined with wood, and 40.0 percent are cleaned once a month. Before the use of the disinfectant solution, having taken the swab from door handles, floors and walls of the toilet and were detected Enterobacter spp, E.Coli, and Pseudomonas spp in all samples.
However, after one and 24 hours of spreading of the disinfectant solution, the amount of intestinal coliform bacteria and E. coli was reduced dramatically and in some places no bacterial were detected. 72% of the soil near the latrines in the study covered ger areas was contaminated with bacteria. In terms of E.Coli contamination in soil, 60% of them were contaminated in low degree and 32% were medium and 8% were high degree. Anaerobic microorganisms such as Cl.prefrings were accounted for 82% of the total sample, 19% moderate and 81% low contamination. Conclusion Intestinal coliform bacteria (Enterobacter spp, E.Coli, Pseudomonas spp) and pathogenic bacteria (Serratia spp, Staphylacoccus spp) were not detected and the number of fungi was sharply reduced after 1 and 24 hours using Hypon disinfectant. No intestinal pathogens (Salmonella spp, Citrobacter freundii) were found in the soil near the latrine. The amount of coli titers was reached to the acceptable limits. According to this study, the disinfection activity of “Gipon” solution was ranging from 105 to 104.

Introduction: Mongolia is one of the most vulnerable countries to climate change due to its geographical location, climate conditions, level of development and lifestyle of the population.
The “Impact of Climate Change on Drinking Water, Health and Adaptability” study report has shown that climate change is affecting the quality and composition of drinking water, drying up many rivers and lakes and reducing groundwater levels.
There was a strong positive correlation between precipitation and air temperature and dysentery, diarrhea and salmonellosis, while there was a strong negative correlation between precipitation, air temperature and viral hepatitis. Goal: The goal of the study was to reveal correlation between meteorology parameters and some intestinal infectious diseases and human health in Mongolia. Material and Methods: We evaluated climate and certain morbidity (intestinal infections) indicators for the last 15 years (2005-2019) using descriptive survey methods. The methodology of the survey has developed and discussed at the Scientific Council meeting of NCPH, 12th of Oct, 2020. The methodology of the survey has developed and discussed at Medical Ethics Reviews Committee of MOH on 23rd. of June, 2021. Results: On the other hand, the average air temperature has intensively risen for the last three decades since 1990 with the warmest average temperature between 2001-2010, whereas the coldest average temperature has been observed between 1951-1960. In 2005-2009, the prevalence of intestinal infections per 10.000 population was 0.8 cases of salmonellosis, 11.2 cases of dysentery, 0.2 cases of diarrhea, and 39.0 instances of hepatitis A. Throughout 2015 and 2019, the prevalence of salmonellosis fell by 0.1 per 10.000 population, dysentery by 2.9, diarrhea by 0.1, and hepatitis A by 0.1. Conclusion A seasonal trend in intestinal infections was observed (p<0.001). Strong positive correlation was found between high temperature and some intestinal infections (hepatitis А, dysentery, salmonellosis) respectively.

Introduction: Beginning 15 May 2019, the consumption of raw coal in Ulaanbaatar has been replaced by the consumption of briquette fuel for the improvement of air quality according to Governmental Resolution No.62 adopted in 2018. Since after this resolution has been in placed the number of CO poisoning has been increased as of 18 December 2019, nine persons were died and 1394 people get a health care service due to CO poisoning. However, it has been not been assessed briquette affect to the indoor air quality and its health impact. Thus, it is need urge to define the indoor air quality effect of briquette and its heath impact. Goal: To assess the indoor air quality of the household using the “improved briquette” and identify the causes of the risk. Material and Method: This a cross-sectional survey, conducted from January 31, 2020 to April 31, 2020, data were obtained by quantitative, qualitative (observation, interview) and direct indoor air quality measurement. The survey sampling frame was 40 households in central 6 districts of Ulaanbaatar that used improved fuels (20 households with a history of carbon monoxide poisoning and 20 households that were not affected), and 14 households in the Nalaikh district that used raw coal, in total of 54 households were participated. Indoor air quality was measured by PM2.5, PM10, CO, SO2, NO2, and microclimate per household for 24 hours during a week.
The statistical data analysis was done by the SPSS-23 program and preformed required parametric and non-parametric tests. The normality of the data was checked by the Kolmogorov-Smirnov test. The most of data was not normally distributed. So, thus we used median and used relevant non-parametric tests. The average level of microclimate indicators, and air quality indicators were defined as mean, median and its IQR and standard deviation. The 95% confidence intervals of mean and frequencies were determined and used to differentiate group differences.
The Ethical permission to start the survey was approved by the 2nd meeting of the Ministry of Health on February 4, 2020. The committee was reviewed and approved the research methodology based on whether data collection technique and tools are considered the ethical issues, and whether provided accurate information for make decisions to enroll to the survey for respondents. Results: According to the health statistic, from October 2, 2019 to March 31, 2020, a total of 2,768 people from 837 households were exposed to carbon monoxide poisoning. Of the total reported cases, 10 were drunk, and 2 were due to other disease complications, and a total of 2,756 cases were confirmed diagnosis as carbon monoxide poisoning.
Emissions of CO were recorded every 15 seconds and the results were calculated by conducting continuous measurements per household for 24 hours a week. The level of CO emitted into the indoor environment of households exposed by carbon monoxide had increased during the following time from 7 am to 9 am in the morning, from 13 pm to 15 pm, from 18 pm to 20 pm in the evening, and from 22 pm to 24 pm at night. During this period of time, the indoor air CO level had increased from the WHO mild poisoning recommendation level. Conclusion It has been defined that the carbon monoxide emits to the indoor air households which are using an improved fuel according to measurement the 30 minutes, 31-60 minutes, and 61-120 minutes after burning.