OBJECTIVES: According to the millennium development goals particularly in the fifth goal it was noted to reduce the incidence of miscarriages into 75% from 1990 till 2016. However, it’s reduced only 34% in worldwide. The incidence of maternal mortality rate have been estimated to 358000 annually, and from 1000 to 1500 maternal death occurred per day.The pregnancy rate have been registered into 40-50 million in Asia Pacific regional countries annually, and the incidence of maternal death is estimated from 30500 to 50000. Moreover, overall 300000 neonates have been died in the first day of prenatal life. There numerous number of studies and surveys in terms of the maternal care have been performed in supports of the “Strategy for women’s and child’s health”, “National program for reproduction” and other projects and national program and other related order, regulation has helped to perform the studies. We aimed to study the pregnancy control in healthy gestational period of pregnancy and to evaluate the counseling for the pregnant women who were admitted to the Family health center in Ulaanbaatar city, Mongolia METHODS: There are 135 pregnant women who are routinely monitored at the Family health centers who were selected randomly, according to the rule number 338 which stated about the pregnancy control, and used questionnaire with 55 questions. The results have been calculated by the SPSS 20 program and statistic information provided by pregnancy monitoring guides. RESULTS: Married women 72.2 % got involved on routine check on time, while only 33.3% women who weren’t married got checked on time. Marital status was also the key factor in women being involved for regular monitoring (p=0.006). Around 70.9 % involved within the 12 week of gestational period were women with higher education, and only 55% of women with secondary education got involved in first examination. Within early monitored women 66.7% of women were aged from 20 to 24, 82.6 percent of women were aged from 30 to 34, 83.3 percent of women who were aged above 35 and higher have been involved in regular checkups on time (p=0.031). Employment has been a factor in checkup attendance. 92.9 percent of women who work at state authorities, 63.6 of women who work in non-government organizations, 51.6 percent of women who are self-employed, 57.9 percent of students, 57.9 percent of unemployed women have participated in checkups on time (p=0.017). 84.9% of women with higher education have been examined on routine examination; however, only 50% of women with lower education have been examined on routine examination. The women with spouses have been examined on routine examination is estimated to 87.6%; however, 75% of women with unclear marital status have been examined on routine examination on time. In the study, 100% of women have been examined on time in the first examination. But in the second time it was estimated to 80%, in the third time it was estimated to 75%. CONCLUSION: The attendance of women in the first examination within the 12 week of gestational period has been depending on the education, age, marital status, and employment of the women. Also the women get pregnant for the first time has actively involved in the first and routine examination.

Although in the 5th goal of the millennial development goals it is stated that by within 2015 iscarriages will be reduced by 75% from the year 1990. So far it has been reduced by 34%, only third of its intended goal. Around 358.000 miscarriages happen in a year, which leads to around 1000-1500 miscarriages per day during numerous stages such as: pregnancy, labor, or after birth. Thisproblem has been gathering a lot of attention around the world that it had been added in to the goalsof the millennium development goals. Of the 130 million babies who are born in a year 7.6 millionof them are born with birth defects and 3.2 million die while they are still infants, and 3.6 millioninfants are left handicapped. Of 40-50 million pregnancies that are reported in Asia and the PacificOceania, 30500-50000 women miscarry, and 300000 infants die within the first day since birth. In the Mongolian government’s population development policy, it is stated that the government shall support population growth, to provide a safe living environment for people to live a long prosperous life, and to improve healthcare services for mothers and babies. The total population as of late 2014 is 2 million 995.9 thousand it has risen up by 65.9 thousand since the previous year a 2.2 percent increase. 48.9 percent of the population are males and 51.1 percent are females the ratio of gender is 96:100 for every 100 females there are 96 males. As for age, 28 percent of the population is under 15 years old, 68 percent of the population is between the ages 15-64, 4 percent of the population is 64 years old or older. We have selected this topic because there are no sufficient scientific researchmaterials regarding to pregnancy monitoring despite there are regular reports being made about pregnancy monitoring in accordance to Mongolia’s maternity orders. 135 pregnant women who are routinely monitored at family healthcare centers were selected randomly, the results have been calculated by the SPSS 20 program and statistic information provided by pregnancy monitoring guides, and by a 48 question survey made in accordance by the 338th rule of the pregnancy monitoring of regularly processed women.Of the total 135 pregnant women, 88 (65.2%) have been checked on time. While 47 (34.8%) haven’t been checked on time. Furthermore, of women who are married 72.2 % got checked on time while only a third of the women who weren’t married (33.3%) got checked on time. Marital status was also a key factor in women being on time for regular monitoring (p=0.006). Around 70 percent ofwomen with higher education have shown up on time for regular monitoring whereas only 55 percent of women with secondary education got monitored. Considering the age structure 66.7 percent of women aged 20-24, 82.6 percent of women aged 30-34, 83.3 percent of women aged 35 and higher have been involved in regular checks on time. (p=0.031). Employment has been a factor in checkupattendance. 92.9 percent of women who work at state authorities, 63.6 of women who work in nongovernmentorganizations, 51.6 percent of women who are self-employed, 57.9 percent of students,57.9 percent of unemployed women have participated in checkups on time.(p=0.017).From the women who were surveyed, 57 (41.3%) women who didn’t show up on time for their second examination, by the looks of the women 10(83.3%) who went in monitoring on the second three months into pregnancy were pregnant before. It is clear that the women who were pregnant before lose concern about being monitored.87 (63%) of the women took pregnancy class, of the 51 (37%) who didn’t 13 (15%) took the class because they weren’t able to claim their pregnancy benefits and 35 (68.8%) of the women who didn’t take the pregnancy class have stated that they hadn’t had the time. 16 (31.4%) have claimed that it wasn’t needed. This shows that class attendance is insufficient and people only attend to claim their pregnancy benefits. Because of the lack of special service for pregnant women at district hospitals, women are forced to get service elsewhere. It is clear that local doctors give little advice and information about birth, miscarriage and prevention of misbirth.

Introduction: According to the statistical data of health organization 43% of all diseases and 60% of all deaths are due to chronic diseases including cardiovascular diseases, diabetes mellitus and cancer. Many factors contribute to the wide spread of noncommunicable diseases (NCDs)1. As defined in the World Health Report 2002, many common risk factors such as unhealthy diet, physical inactivity, smoking, alcohol use, overweight, raised blood pressure, raised total cholesterol levels and blood sugar are the most prevalent risk factors among the world population. In conclusion, the Mongolian NCD STEPs survey of 2006 revealed that 9 in every 10 people had at least one risk factors for developing NCDs. One in every 5 people had three and more risk factors for developing NCD3. However, partial studies of NCDs, which are dominant in Mongolia, had been conducted previously; the possibilities of wide use of the results are limited and those studies covered only adult people. So it is very important to evaluate knowledge about nutrition and food, tendency and practical experience about life style, activity of motion and use of food among the children.Objective: The goal of the study was to determine the prevalence of risk factors for NCDs among schoolchildren and to develop recommendation and suggestion for prevention of non communicable diseases.Materials and Methods: The survey covered 1504 students, studying in 20 middle and high schools, which are located 5 districts of UB, and was conducted by cross-sectional methods using questionnaire and anthropometric measurements (height, weight and BMI).Results and Conclusion: 31.3% of surveyed population did not consume any serving size of fruits per day, 68.7% consumed less than 5 serving sizes. The second common source of fat was fatty meat and butter. The prevalence of tobacco use was 6.1% of the surveyed population. School children do sedentary work, which has low energy consumption, after class. They watch TV for 3.53±1.24 hours and work on computer 2.83±1.07 hours a day. Percentage of the students who involved in some kind of sports activities is 71.2%, whereas 28.8% of them do not do any physical exercise. The reason why they do not participate in sports activities was determined as follows: do not have enough free time 37.2%, do not like sports 5.3%, due to high fees 35.1%, and inconvenient locations of sport facilities 18.2%. Although the laws, resolutions and regulations, supporting public sports are enough, the structure and action of the units that implement, evaluate and control these laws and regulations are weak.

There is a little information about weight excess of school materials in Ulaanbaatar, Mongolia. The aim of this study was to study of the weight of backback and the ergonomic effects of backpack carriage on school students in Ulaanbaatar. This cross-sectional study was performed in the city of Ulaanbaatar in 2015. Two hundred fourteen school students participated in study. Nordic Musculoskeletal Questionnaire was used, asking about complaints of neck, shoulders, upper and lower back. Length and weight of the children were determined. Backpacks were weighed and the relative weight of the backpack was calculated.In this study, first and second grades students carried proportionately heavier backpacks than older students and more than 10% of their weight. Musculoskeletal complaints were reported by about 79% of school students. The (relative) weight of backpacks was not related to complaints of neck, shoulders, upper and lower back.

Introduction. An uncommon complication of radial arterial blood sampling/cannulation is disruption ofthe artery (obstruction by clot), placing the hand at risk of ischemia. Those people who lack the dualsupply are at much greater risk of ischemia. The risk can be reduced by performing Allen’s test beforehand. People who have a single blood supply in one hand often have a dual supply in the other, allowingthe practitioner to take blood from the side with dual supply.The utility of the Allen’s test is questionable,[1] and no direct correlation with reduced ischemiccomplications of radial artery cannulation have ever been proven. In 1983, Slogoff and colleaguesreviewed 1,782 radial artery cannulations and found that 25% of them resulted in complete radial arteryocclusion, without apparent adverse effects.[2] A number of reports have been published in whichpermanent ischemic sequelae occurred even in the presence of a normal Allen’s test.[3, 4] In addition,the results of Allen’s tests do not appear to correlate with distal blood flow as demonstrated by fluorescein dye injections.[5, 6]Goal. Transradial coronary catheterization across the whole spectrum of Allen’s test results was safeand feasible to address the current uncertainty about the predictive capacity of the Allen’s test fortransradial access.Materials and Methods: This type of descriptive research methods. The patients assisted by SSCHand there were between the ages of 54-88, totally 28 patients. The hand is elevated and the patient/person is asked to make a fist for about 30 seconds.Pressure is applied over the ulnar and the radial arteries so as to occlude both of them.Still elevated, the hand is then opened. It should appear blanched (pallor can be observed at the fingernails). Ulnar pressure is released and the color should return in 7 seconds. If color returns as describedabove, the Allen’s test is considered to be “POSITIVE.” If color fails to return, the test is considered“NEGATIVE” and the ulnar artery supply to the hand is not sufficient. The radial artery therefore cannotbe safely pricked/cannulated.ResultPatients with non-normal Allen’s test results 32.1%.There weren’t any correlation of probability between positive Allen’s test and myocardial infarction, postPCI procedure (p value >0.05).There were correlation of probability between positive Allen’s test and dyslipidemia, DM (p value<0.05).Conclusion:1. We need perform Allen’s test indispensably when transradial coronary catheterization, becausethere were positive Allen’s test not small percent.2. There aren’t additional risk with old myocardial infarction and post PCI procedure patients, becausethere weren’t any correlation.3. There were correlation of probability between positive Allen’s test and dyslipidemia, DM. Thereforedoctors should select artery femoralis if patient have dyslipidemia and DM.

Introduction: The World Health Organization describes poor adherence as the most important cause of uncontrolled blood pressure and estimates that 50–70% of people do not take their antihypertensive medication as prescribed.Goal was to measure non-adherence to antihypertensive therapy in a representative sample of the hypertensive Mongolian population and to define the factors associated with non-adherence in the studied population.Materials and Methods:This descriptive study was a questionnaire-based cross sectional analysis. A simple random sample of 735 hypertensive patients, aged 35-64 years was selected. The questionnaire included sociodemographic characteristics and awareness about hypertension and anti-hypertensive treatment, and factors that encouraged or discouraged the patient’s drug taking behavior. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS), with a 4-item questionnaire. Blood pressure was measured twice by the physicians using aneroid sphygmomanometers and stethoscopes. Results and Discussion: The study sample consisted of 265 men (36.1%) and 470 women (63.9%). The mean age of participants was 53.8 ± 8.7 years. The non adherence to medical treatment found in the our study was 68.3% of hypertensive patients. We found younger age (35-44), low family income, not having a regular doctor towards hypertension control, behaviour not taking drug regularly, monotherapy and lack of patient’s knowledge to be the significantly factors influencing on non-adherence to anti-hypertensive medication among Mongolian hypertensive population. The non adherence to antihypertensive treatment found in the current study was higher than that of 25.9%-55.8% found in the study done in Malaysia, Pakistan and Egypt and lower than what a study in the Bangladesh , India and Brazil (74.2%-90.0%)population.Conclusion: The level of adherence to treatment among the participants in this study seriously needs to be improved through well designed health promotion and education strategies in order to prevent poor treatment outcomes.

Background According to the report of World Congress of Cardiology in 2007, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition. In our country, some study had provided estimation of risk factors and prevalence of hypertension, but main characteristics presenting the early detection and control of hypertension have not been studied well and information does not exist.The quality of the control, registration and early detection of hypertension will be improved by studying this topic and complications and mortality due to the hypertension could be decreased.GoalThe aim of our study is to evaluate the current situation of the early detection, registration and control of hypertension, and to describe future strategyObjectives:1. To describe the hypertension awareness and risk factors associated with early detection of hypertension2. To evaluate the current situation of registration system of hypertension and to find out the strategies for renewing registration system3. To investigate the rates of the treatment and control of hypertension, and to survey factors associated with the control of hypertensionMaterials and MethodIt was population based, cross sectional, prospective study. Participants of the study were selected by randomized method.In the study, 1103 individuals, 133 physicians and 2 family hospitals located in Bayanzurkh, Songinokhairkhan districts, were surveyed. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension awareness (%)• Treatment (%)• Control (%)Software program name: Arterial hypertension registration and control Objectives of the program: to evaluate registration of arterial hypertension, to detect earlier, to determine control level of hypertension Users: family hospitals, family doctorsType of morbidity registration: population basedStatistical analysis was performed with SPSS-17 software program. Single- and multi-factorial analysis was explored by using simple and logistic regression and significance.ResultsIn the study, in total, 1103 people aged of ≥18 years living in Bayanzurkh and Songinokharkhan districts of Ulaanbaatar, have been involved. 37% of all participants were male and 63% were female and mean age of all participants was 40.6±16.1. According to our study, 305 individuals of 431 hypertensive participants (70.8%) were aware of their hypertension. This result was different in gender: 58.0% in male, 79.0% in female. Our research team created software program that can integrate all hypertension data to one database. We are planning to determine unawereness; aware and treated; treated and controlled; and uncontrolled levels by using this software and to introduce the program created by us to all primary level physicians in order to use routinely.Conclusions:1. Among hypertensive individuals, awareness of hypertension was 70.8%. Factors such as young age (<35), single people and not measuring BP for the last one year influence negatively on early detection of hypertension (p<0.05).2. Current method of hypertension registration is not proper at the time. Therefore, we concluded that renewing of the arterial hypertension registration database and conversion it into electronic type is convenient to control arterial hypertension and to provide integration.3. Treatment level of arterial hypertension was 39.9%, controlled arterial hypertension among all hypertensive population - 10.2% and among treated population – 25.2%.

BACKGROUND: Tuberculosis (TB) morbidity and mortality has been one of the pressing issues in the health sector of our country. In Mongolia, 2 people out of 1000 people developed tuberculosis annually, which leads to becoming one of the 7 countries with high TB morbidity among 37 countries of the Western Pacifi c Region.OBJECTIVE: The aim of the study is to have the baseline to understand and measure knowledge, attitudes and practices regarding tuberculosis among non-tuberculosis health care workers including family group practitioners, nurses and specialized doctors at the primary, secondary and tertiary health care level of Mongolia.MATERIALS AND METHOD: Cross-sectional descriptive qualitative study. Self-admitted questionnaire were performed for 572 health care workers. Total of 4 aimags/provinces and 3 districts were randomly selected. Selenge, Darkhan-Uul, and Khentii aimags are regions with high tuberculosis burden, Dornogobi and Orkhon aimags are with low Tuberculosis incidence and prevalence in 2008.Altogether 572 doctors and health professionals from selected health facilities were involved in survey questionnaire and 39.9% (228 people) of respondents were working at the primary level, 31.3% (179 people) in secondary level, and 28.8% (165 people) in the tertiary level health facility, respectively. Altogether 23 focus group discussions were organized, involving 130 people.RESULTS: Around 98.6% of respondents answered that TB is spread when infected person coughs and sneezes. However, one of every three respondents answered TB can be transmitted when sharing cups, dishes and other cooking utensils with the infected person, one in every ten people–shaking hands with the infected person, and one in every four people–through mother to child transmission. Such misconception is common among the health professionals, especially among nurses of the secondary and tertiary level health facilities. Around 47.6% or 272 people answered correctly that TB patients have symptoms such as coughing for 2 weeks and longer, develop sputum with blood traces, fever and sweating during night sleep, and loss of weight. However, there is some misunderstanding among the doctors and nurses such as there are skin rashes. When doctors and nurses where asked which form of TB is the infectious one, 86.9% answered correctly that TB with positive smear test is infectious. On assessing the knowledge, attitude and practice on TB treatment, about 93.4% of the respondents answered that treatment shall be done by anti-TB drugs and this result is equally strong among health professionals at all service delivery levels (p=0.075). However, there are some misconceptions among the nurses that TB patients should buy anti-TB drugs from the pharmacies, try traditional medicines and follow religious rituals. This should be paid further attention and issues covering TB should be included in their curriculum. Every second person knows the treatment continuation period of drug susceptible TB patient, which is relatively low knowledge level. According to survey results, every second person knows what DOTS stand for. In other words, 55.4% of the respondents identifi ed correctly what is DOTS, and 13.8% answered that it is a combination of anti-TB drugs, 3 .3% - as TB treatment method, 5.6% - as combination of TB reduction measures, and 2.2% answered that they don’t know.CONCLUSION: Many misunderstandings were found in the fi eld of transmission, BCG vaccination, treatment and anti-TB drugs. There is a need to provide training for non-TB medical doctors and nurses.

BackgroundAn estimated 522 066 students are studying in secondary school of Mongolia and it was 19% of total population. Population life expectancy and health status is directly related to adolescents’ health, as many chronic disease conditions are affiliated with adolescence. Many premature deaths among adults result from behavior initiated during adolescence. According to the NRC survey, one in thirteen schoolchildren (7.3%) was underweight, 16.3% was stunting, and 13.8% were iodine deficiency. It has taken 52.8% of total daily energy among 11-14 years schoolchildren and 50.5% were between 15 and 17 ages. In addition, research in Mongolia in 2005 indicate serious problems in healthy eating behavior; 8% of adolescents consumed milk products on daily basis, 71.7% had breakfast only sometimes, and 83.2% had a meal one time per day. Micronutrient deficiency such as anemia, A, D vitamins among them is cause of low consumption of vegetable and fruits. There is a need to study schoolchildren’s dietary recall.ObjectiveTo study and evaluate schoolchildren’s nutritional statusMaterials and MethodsThe descriptive and cross sectional study was carried out in 4 districts of Ulaanbaatar city (750 schoolchildren from each district) and 2 aimags (889 schoolchildren from Uvurkhangai and 925 from Dornod) of Mongolia. Also determined current nutrition situation of surveyed schoolchildren by using 24 hours recall method and assessed.ResultA total of 4760 (46.6% boys and 53.4% girls) school children surveyed and 46.6% were boys and 53.4% were girls. 71.7 percent of total respondents have breakfast sometimes, 83.2 of them have a lunch only one time per day, and 38.3 percent of total daily energy takes from dinner and have not any difference between age groups. Adolescent aged 7-10 years takes 92.7 percent of total calorie, 90.1 percent of protein, 93.9 percent of carbohydrate and 92.3 percent of fat compared to RDI of Mongolia and thus animale fat is the 1.6 times more than the norm. Consumption of vitamins and minerials such as vitamin A, and iron8 calcium were insufficient among schoolchildren. Specially, it was lower among male student than female. For instance vitamin C intake was 48.0- 58.6 percent among female students aged above 11 years and it was 47.3- 51.8 percent for male students. About 30 percent of total calcium is consumed per day among overal respondents. Conclusions:1. Daily intake of basic nutrients and energy is lower by 10-30 percent than RDI of Mongolia among schoolchildren.2. High consumption of in diet among male adolescents of age 15 years and above causes disbalance of adequate ratio of main nutrients as protein8 fat and carbohydrates.3. There is not enough suffecient consumption of vitamins and minerials specially calcium.

IntroductionStudies on structure and function of reproductive system of experimental animal by developing coldstress model have been getting attractions from researchers. The study on changes of reproductive system of offspring from experimental animal which had cold stress has been done in recent times.GoalCold stress modeling in female experiment rats and, identifying the changes of stages of estrous cycleand reproductive hormone.Materials and MethodsIn order to identify stages of changes of reproductive hormone of experiment female rat which is model of cold stress, 90 Wistar breeding rats weight of 170-178 g were divided into following 6 groups:Non-gravid control group–15, gravid control group–15, non-gravid group for cold stress–15:15:15, gravid group for cold stress–15. Pathologic cold stress was modeled in 15:15:15 rats of non-gravid group for cold stress by putting in fridge everyday between 8 to 11 o’clock for 7:14:21 days and in 15 rats of gravid group for cold stress by putting in fridge (-150) every day between 8 to 11 o’clock for 28 to 30 days (Avcina AP(1989), Melovanov АP(1991)). Time to vaginal opening was determined to use method of Volkova OB in offspring of gravid experiment rats and control group after 2 months. After that selected 15 female offspring were put to sleep with ether and taken blood of 4-5 ml from their hearts and compared the amount of estradiol and progesterone in that blood using rat kits of Ausmausco Pharma with control group.Result Determining hormone level in blood of control group, estradiol is 4.73±0.45ng/l, progesterone is 2, 45±0,50ng/l. After a week pathologic cold stress was modeled in rats, estradiol is determined 3.93±0.70ng/l, progesterone is determined and after 2 weeks, estradiol is 4.0±0.53ng/l, progesterone is 1.97ng/l and after 3 weeks, estradiol is 3,8±0,63ng/l, progesterone is 1,94±0,09ng/l Birth weight of offspring from gravid rats with cold stress, was 1,6g (р=0,001) less than control group.Time to vaginal opening of offspring was 14 days later than control group. Determining hormone of control group offspring, estradiol is 4.53±0.51ng/l, progesterone is 2,39±0,40ng/l. Estradiol is 3.73±0,59.ng/l, progesterone is determined 1.97±0.07ng/l in offspring of gravid experiment rats.Conclusion: 1. When develop cold stress model, gravid rats had miscarriage and preterm delivery and born low birth-weight offspring in 16-22 days of experiment and this reveals that pathologic changes occurred in sexual hormonal regulation of 3 groups of non-gravid rats of experiment because of cold stress. 3. In offspring from gravid rats which had cold stress time of vaginal opening was lengthened and estradiol and progesterone level was decreased in offspring from gravid rats and