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.

According to the 2013 WHO survey, the world’s leading cause of death is a coronary heart disease which is accounted for 12.9%. Bypass surgery by grafting Artery mammaria interna to the left anterior descending coronary artery is more clinically significant and has long become an international standard. Aim: To study the outcomes in patients who undergone a bypass surgery ofgrafting the Artery mammaria interna to the left anterior descending coronary artery in an open heart surgery. In 2014 in the case-control study conducted at the Shastin 3rd National Central Hospital, 8 patients who undergone a bypass surgery of grafing Artery mammaria internasinistra to the left anterior descending coronary artery were selected for a case group and 8 patients with bypass grafting of a superficial vein of the leg to the coronary artery were selected as a control group. Related diseases, heart function, type of grafting performed, and post-operative complications were studied. The successful bypass surgeries of grafting the Artery mammaria interna sinistra to the left anterior descending coronary artery without complications in the case group in 2014 has demonstrated that the Mongolian cardiosurgical team was able to successfully and fully introduce this innovative approach that has become an international standard of coronary artery surgery. The introduction of this method enables to eliminate angina pectoris symptoms in patients, restore and improve heart contractions, reduce the chances of a repeat heart attack, and thus, to improve the patient’s ability to live and work normally.

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.

Aim and objectivesTo assess the community health seeking behavior, knowledge, attitude, practice and the attitude ofprimary health care providers and to determine methodologies for developing of voluntary attendanceof preventive screening services. This included:• Assessment of community knowledge, attitude and practice related with preventive healthservices and health seeking behavior;• Assessment of the attitude of primary health care providers on preventive healthservices;• Identify methodologies to establish a practice of voluntary attendance of preventivescreening services;Materials and MethodsIn this survey both quantitative and qualitative research methods were used. 846 individuals wereinvolved in the quantitative survey and 112 family doctors, nurses, social workers of the selectedaimags and districts participated in the qualitative surveys.ResultsThough the participants demonstrate knowledge that the primary health care facilities should beapproached on the initiative of the patients themselves (85%), while healthy (50%) and for earlydetection of a disease (70%), this knowledge on preventive care is not evolving into actual practiceas most of them visit the primary care facilities only as they become sick (70%). The communityparticipants demonstrate incorrect attitude that preventive services do not require personal initiativesand engagement of patients (42%), primary care facilities are visited in order to obtain a referral tothe next level of care (46%), primary care facilities should be visited only when there are symptoms ofdiseases (32%) and only when the patient has free time. The participants of the survey also noted theinsufficient attitude and communication manners of the doctors and health professionals (31%), thatpatients are not received with smile when they visit for preventive screening (60%), dissatisfaction withthe services of primary care facilities (28%).ConclusionsThe majority of the respondents know that visit to primary health care clinic for health check-up isrequired. Although most of the participants demonstrate knowledge that primary health care unitsshould be visited voluntarily for preventive screening services, most do not practice this knowledge.The attitude of most of the participants was that the benefit of visiting a primary care facility is obtaininga referral to the specialist doctor. One out of three of the survey participants had an incorrect attitude asthey perceive that health check-up is only necessary if a patient is sick with one or more conditions.

Electronic cigarettes are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. The e-liquid typically contains humectants and flavorings, with or without nicotine; once vaporized by the atomizer, the aerosol (vapor) provides a sensation like tobacco also smoking the heating process can lead to the generation of new decomposition compounds that may be hazardous. Heavy metals, organic compounds, and particles smaller than PM2.5 were found on the puff of the electronic cigarette, also in 2012 International agency research cancer, introduced PM2.5 human carcinogen substance. Therefore, e-cigarette liquid products should be subjected to regulatory control to ensure consistent nicotine delivery. Global youth tobacco survey Mongolia 2019 asked about e-cigarette use status and 3.5% (95% CI: 2.6-4.6) of students currently used electronic cigarettes while one in ten students (10.1%, 95% CI: 8.3-12.2) had ever used electronic cigarettes. E-cigarette advertising is on television and radio in many countries that have long banned similar advertising for cigarettes and other tobacco products and may be indirectly promoting smoking conventional cigarettes. Smoke-free policies protect nonsmokers from exposure to toxins and encourage smoking cessation. Introducing e-cigarettes into clean air environments may result in population harm if use of the product reinforces the act of smoking as socially acceptable or if use undermines the benefits of smoke-free policies.

Background: As a result of the previous programmes implemented by the Government of Mongolia, maternal mortality and under-five mortality rates had declined fourfold from 1990 levels to 2015 The Millennium Development Goals (50.0), shifting from a country with a high maternal mortality rate to a country with a moderate maternal mortality rate [6, 7, 8, 9]. However, as maternal and child mortality have not been steadily declining, regional disparities in care have not been eliminated, unmet needs for family planning have increased, contraception use has reduced, abortions and repeat abortions have not decreased. The quality of antenatal care is low; the continuing challenges have led to the development and implementation of the 5^th National Programme. As the programme was finished in 2016-2020, assessing its impact on Mongolia is significant. Objective: Evaluating the objectives of the National on Maternal, Child and Reproductive Health Programme, the implementation of planned activities, whether the intended results have been achieved according to the criteria was to determine future needs and the main areas of focus. Materials and Methods: Quantitative and qualitative methods were used to analyse the information required for the assessment. The activities of the programme implementation plan were evaluated in the form of activities implemented in 2016-2020 and time spent on implementation, which implemented, who was involved, the budget spent, the type and the number of beneficiaries, and the reasons for nonimplementation. Results: A total of 28 indicators of the National Program was 76.8 percent. In 2016, by the time the programme was launched, the under-five mortality rate was 20.8 per 1000 live births. However, the goal to reach 15 in 2021 was achieved to reach 12.7 by successfully implementing the programme. The program aimed to reduce the maternal mortality rate from 48.6 per 100000 live births to 25 per 100000 live births in 2021, but has not yet been achieved, reaching 30.2 in 2020 and 43 in the first five months of 2021. Initially, the program implementation plan included cooperation with more than 600 organisations, such as 9 ministries, 14 government organizations, 21 provinces, health centers, and maternity hospitals. However, an excessive number of organizations and an unnecessary amount of planned work made it impossible to identify the beneficiaries in addition to the Government of Mongolia, donors such as UNFPA, UNICEF, and WHO made a significant contribution to the implementation of the programme by providing financial and technical assistance. As of 2017-2021, no funds had been found to implement the National Programme on how much has been spent on information, publicity, and advocacy measures. According to the interviews with the programme implementers, a lack of leadership, lack of proper planning, turnover in the civil servants, and the ongoing pandemic had resulted in the lack of a transparent annual implementation plan, the insufficient time and resources for next year’s planning and implementation of the planned work, and the lack of budget resources. Conclusion As the total of 28 indicators of the National Programme was 76.8 percent, it has been evaluated as having achieved specific results.

Background: As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population. Goal : This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results Material and Methods: This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. Results: Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. Conclusions As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

BACKGROUND: In Ulaanbaatar, the first case of the pandemic influenza infection has been reported on 12 October 2010.By November 9, a total of 929 cases laboratory-confirmed had been reported to National Center for CommunicableDiseases (NCCD). Of these cases reported, 9 people died.METHODS: The objectives of the study were to describe patients who admitted and hospitalized at NCCD and to determineoverall attack rates among health workers, secondary attack rates among students of colleges and universities. Datawas analyzed using Epi-Info2000.RESULTS: Among 929 of laboratory-confirmed cases, 50.3% (95% CI 43.0-57.5) were males aged 23 (±14.9) in averagewith youngest – 7 months, oldest – 76 years old. Data analysis by districts among the hospitalized patients, showed32.8% (139) of total cases in Bayanzurkh district including the first case of the pandemic influenza infection. The majorityof patients who admitted and hospitalized to NCCD mostly experienced fever (288, 68.1%), dry cough (251, 59.3%),headache (203, 48.0%), sore throat (175, 41.6%). With 1020 physicians and health workers in total, 41.4% (422) ofthem work at NCCD, 35.4% (361) – at MCHRC. 11.1% of health workers out of total become ill with pandemic H1N12009 (overall attack rate 11.1%) with the most common symptom, 380C and higher fever (100.0%, 113), sore throat(83.2%, 94), cough (76.1%, 86) and runny nose (59.3%, 67). The higher attack rates of health workers by occupationwere doctor (18.0%) and auxiliary (13%). The secondary attack rates among university students for influenza-likeillness(ILI) were 12.9%. These secondary attack rates were higher among students of art’s college as compared withother universities (52.4%). For students, the main clinical symptoms were fever + sore throat (75.0%, 18), fever+ cough(70.8%, 17).DISCUSSION: In China, as of 27 September, 2009, from reported total 19981 cases infected with pandemic influenza,61.0% were males, mean age was 17, mainly affected with 83% school students that consistent with our study result.The similar results on clinical symptoms were obtained in Russia. Out of 130 patients, 28.6% had 380Ñ and higherfever, for 54.3% the body temperature reached 38.1-390Ñ where as 17.1% - higher 390Ñ and 96% had cough, 89%had muscle ache, 65% had headache, 14% had diarrhea.

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.