AIMAim of this study was to evaluate Predicted 4 and 10-years risk of major CVD of DMpatients.METHODSCross-sectional study included 80 (40 male and 40 female) DM patients with meanage 66.32 ±7.94 years old. Predicted 4-year risk of major CVD was calculated by usingADVANCE Risk Engine of the George Institute for Global Health, Australia. Ten parameters(age at diagnosed diabetes, duration of diabetes, sex, atrial fibrillation, retinopathy,HbA1C, pulse pressure, treated hypertension, albuminuria and Non HDL-cholesterol)were used for risk calculation. Predicted 10-year risk of major CVD was calculated byusing WHO/ISH risk prediction chartrs Parameters (age, sex, systolic blood pressure, totalcholesterol, smoking) were used for risk calculation.RESULTSOur study relieved that average of diagnosis diabetes was 54.98±9.37 years oldand mean diabetes duration was 11.35±7.46 years. DM patient with atrial fibrillation,retinopathy and treated hypertension were 0(0%), 20(16%) and 77.5(62%). Mean HbA1C,microalbuminuria and Non HDL cholesterol were 7.74±1.5%, 49.99±94.02 mg/l and3.61±1.08 mmol/l. DM patients with <10%, 11-20% and >20% Predicted 4-year riskof major CVD were 64( 80%), 12 (15%) and 4(5.0%). Age (p<0.042), age at diagnoseddiabetes (p=0.013), duration of diabetes (p=0.045), total cholesterol (p<0.027)Microalbuminuria (p<0.001) and retinopathy (p=0.028) were risks for Predicted 4-yearrisk of major CVD.DM patients with <10%, 11-20%, 20-30%, >30% Predicted 10-year risk of major CVDwere 44 (55%), 20 (25%), 6 (7.5.0%) and 10 (12.5%). Age (p=0.008), total cholesterol(p=0.001), systolic blood pressure (p=0.001) and treated hypertension (p=0.023) wererisks for Predicted 10-year risk of major CVD.CONCLUSIONSAmong the diabetic patients 80% have a low, 15% have a moderate and 5.0%have a high Predicted 4-year risk of major CVD. Age (p<0.042), age at diagnoseddiabetes (p=0.013), , duration of diabetes (p=0.045), total cholesterol (p<0.027)Microalbuminuria (p<0.001) and retinopathy (p=0.028) were risks for Predicted 4-yearrisk of major CVD. Among the diabetic patients 55% have a low, 25% have a moderate,7.5% have a high and 12.5% have a very high Predicted 10-year risk of major CVD. Age(p=0.008), total cholesterol (p=0.00, systolic blood pressure (p=0.001) and treatedhypertension (p=0.023) were risks for Predicted 10-year risk of major CVD.

Background: Since life style of the nation has changed, the prevalence of T2DM has steadily increased. According to T2DM related studies, estimated number of people with diabetes is 80.000 in Mongolia. Despite this, total number of diabetic patients registered in Mongolia is only 7000. Thus, approximately 90% of people with diabetes are undiagnosed and untreated.Objective: to assess anthropometric and laboratory parameters of newly diagnosed patients with T2DM.Materials and Methods: It was cross sectional study included 133 patients with type 2 diabetes newly diagnosed at the district hospital of Ulaanbaatar. We measured height, weight and waist circumference and analyzed body fat by bio-impedance analyzer machine. Fasting blood glucose, HbA1c, triglyceride, HDL-C, LDL-C were determined by methods of laboratory in venous plasma. We defined as subjects with metabolic syndrome used the IDF new definition of 2009.Results: 44.4% of all participants were male and 55.6% were female and mean age of all participants was 49.1±8.5. According to BMI 85.7% of patients was obese and overweight and 84.2% of patients identified central obesity by measuring waist circumference. In analyzing of body composition, 100% of all patients determined high body fat. 27.1% of men and 36.4% of women diagnosed arterial hypertension. According to HbA1c (%) level the 94% of patients determined 7.5 and above. The hypertriglyceridemia was 59.4%, hyper LDL-C was 76.7% and hypo HDL-C was 12% and increased LDL: HDL ratio was 8.1%. The prevalence of metabolic syndrome among the newly diagnosed patients with T2DM was 69.6%, male 66.1% and female 72.9%. Conclusion: Obese is major risk factor for T2DM in Mongolia. The study shows that assessing body fat is major identifying method of obese (p<0.03) and statistically significant association of high body fat mass with WC in diabetic patients (p<0.05). The prevalence of several risk factors of DM complications among newly diagnosed patients with T2DM is higher.

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: A midwifery services are recognized as one of essential health care and services. The amplification of trained midwives plays very important role to improve the quality of and access to health care services as highlighted in the global Human Development Report [1]. Obstetric care is the integrated specialized interventions aimed to detect, monitor, manage delivery, treat and prevent illnesses of mothers, fetus and newborns in pregnancy, childbirth and postnatal periods. Every year, 287,000 women die from complications related to pregnancy and childbirth, and 2.9 million newborns die before they reach the age of four weeks worldwide. The majority of the preventable maternal and newborn deaths occur in low-income countries [3]. Goal: This assessment was aimed to review the current situation and legal framework of midwifery services and comprehensive competencies of midwives, and to provide baseline data for the project as well as evidence based recommendations for further improvement of midwifery services in Mongolia. Materials and Methods: In order to assess the current status of midwifery services and integrated competencies of midwives, a range of quantitative and qualitative methods were used. A cross- sectional study for assessing the quality of obstetric care and practice was conducted by using observation checklists, questionnaires and interview guides. Midwives who are providing obstetric care in Mongolia were involved in the assessment. Results: A total of 321 midwives from NCMCH, and 2 maternity hospitals of Ulaanbaatar and 21 aimags were involved in the assessment. Out of them 97.2% were female and the mean age was 37.2±10.1 [95%CI: 36.03-38.21]. The mean of working years in health sector was 14.54±10.9 years and mean of working years with the current institution was 11.7±10.1 years. Minimum work experience was few months and maximum was 38 years. A majority of the assessed midwives hold some abilities sufficiently such as keeping medical documents during pregnancy [4.23; 95%CI: 4.15-4.32], educating and giving advice to the customers about after and before the pregnancy period [4.01; 95%CI: 3.91-4.11]. A majority of the assessed midwives answered holding some abilities as important, such as basic knowledge of mother and child public health care in the fertility system [4.11; 95%CI:4.00-4.21], implementing experiences [4.07; 95%CI:3.97-4.19], and very important documents for the Obstetricians Association to know about midwives’ practical and professional activity [4.05; 95%CI:3.92-4.17]. None of the midwives took “A” or point indicates highest level. 40.5 percent of assessed midwives took “D” or “Able to make a relatively easy content; Lack of general knowledge, skills and practices”. One third of participated midwives took “F” indicating lack of knowledge, skill and practice. Moreover, one fifth of the midwives took “C” indicating average level, understood most of the content, skilled moderately, and prepared enough to practice more in this field. Even though rural midwives got average level (22.0%) score 4.1 functions more than city midwives, it didn’t have any difference in the statistic correlation. 3.3 percent of all participant 7 midwives took “B” indicating above the average level in the knowledge test. The midwives have told training for them hadn’t organized frequently which is shown in the quality assessment. Conclusions Furthermore, it is necessary to increase the skill of midwives who would perform complex care based on clinical evidence to reveal the risks faced to maternal and infant health, prevent from degradation and manage safe birth.

Background: Age-related macular degeneration (AMD) is an eye condition, that occurs people aged above 50, leads to gradual loss of the vision because of a damage in the macula, which is located in the center of the retina. Several polymorphisms in different genes have been proposed as factors that increase the disease susceptibility. Therefore, we investigated the association between rs833061 polymorphism of VEGF-A gene and rs10490924 polymorphism of ARMS2 gene and AMD in order to analyze with other similar studies by meta analysis. Purpose: To investigate the polymorphisms of VEGF-A gene and ARMS2 gene on AMD susceptibility Methods: is case-control study was conducted on 74 AMD patients and 32 unaffected age-and gender-matched control individuals. Genomic DNA was extracted from the peripheral venous blood. The single nucleotide polymorphisms were identified by restriction fragment length polymorphism (RFLP) method and results confirmed by gel electrophoresis. The REVIEW MANAGER 5.2 software and MetaXL was used for meta-analysis Results: We did not find statistically significant differences in С allele and СС genotype frequency of rs833061 polymorphism of VEGF-A gene between patients and controls. However, analysis of rs10490924 polymorphism of ARMS2 gene shows that T allele (OR=2.72, 95% CI, 1.47 – 5.02, p=0.001), TT genotype (OR=4.54, 95% CI, 1.49 – 13.87,p=0.019) were significantly associated with AMD risk. Haplotype analysis of these SNPs showed that C+T haplotype was statistically significantly different (OR=5.23, 95% CI, 1.76-15.54, p=0.002) between patients and controls. Conclusion As shown by results, rs10490924 polymorphism of ARMS2 gene show that T allele, TT genotype and C+T haplotype were significantly associated with AMD risk In meta-analysis, T allele of rs10490924 polymorphism of ARMS2 gene was significantly associated with AMD risk in all ethnicity that include Asian and Caucasian. However, T allele prevalence was higher in Asians.