Background: The continuous annual increase in the prevalence of diabetes mellitus (DM) poses significant challenges not only within our nation but also globally in the control and management of tuberculosis. Aim: This study aimed to determine the incidence of pulmonary tuberculosis among individuals with type 2 diabetes mellitus (T2DM) residing in six central districts of Ulaanbaatar and to investigate associated factors. Materials and Methods: A cross-sectional study design was employed. Participants aged 18 years and older diagnosed with T2DM and receiving care at endocrinology clinics in six central districts of Ulaanbaatar were selected using systematic random sampling. Presumptive TB cases were identified through a structured questionnaire and chest X-ray. Sputum specimens were collected and subjected to smear microscopy and Xpert MTB/RIF assay for tuberculosis detection. Cases confirmed by laboratory diagnosis, currently undergoing tuberculosis treatment and previously treated cases as per questionnaire data were classified as tuberculosis cases, and prevalence was calculated. Results: A total of 1,644 individuals with T2DM were enrolled in the study, of whom 836 (50.9%) were female, with a mean age of 58 years (range 19–89). The overall prevalence of presumptive TB cases was 10.5% (n=172; 95% CI, 9.0–12.0). Among 112 suspected cases from whom sputum samples were obtained, 10 (8.9%; 95% CI, 4.9–15.7) were laboratory-confirmed for M.tuberculosis. Notably, 7.2% (6 cases; 95% CI, 3.4–14.9) of asymptomatic individuals with abnormal X-ray findings were diagnosed with tuberculosis. According to questionnaire responses, 9 participants (0.5%; 95% CI, 0.3–1.0) were undergoing tuberculosis treatment, and 53 (3.2%; 95% CI, 2.5–4.2) reported a previously treated TB cases. The overall prevalence of tuberculosis among individuals with diabetes was 4.4% (n=72; 95% CI, 3.5–5.5). Stratification by age and sex revealed a significantly higher prevalence among males (5.9%; n=48; 95% CI, 4.5–7.8) compared to females (2.9%; 95% CI, 1.2–4.2) (p=0.002), indicating a twofold increased risk of tuberculosis in males. Although no statistically significant differences in tuberculosis prevalence were observed across age groups (p>0.05), a declining trend in prevalence with older age was noted. Conclusion The prevalence of tuberculosis among individuals with type 2 diabetes was 4.4% (n=72; 95% CI, 3.5–5.5), with a significantly higher rate in males (p=0.002) and a decreasing trend with increasing age. Among asymptomatic individuals exhibiting radiographic abnormalities, 7.2% were confirmed to have tuberculosis via laboratory testing

Introduction: Health care workers of First Central Hospital of Mongolia have vaccinated with three different vaccines against SARS-CoV-2. We detected SARS-CoV-2 N and S-RBD antibodies after 30-90 days of second dose of vaccination. Method: Quantitation of antibodies to the spike protein of SARS-CoV-2 was performed for the detection of adaptive immune response in 291 HCWs vaccinated with Covishield, Sinopharm and Pfizer Biontech. Detection and quantitation of SARS-CoV-2 N and S antibodies were performed by the electrochemiluminesce assay Cobas e411, Roche. Result: SARS-CoV-2-S-RBD IgG titer were negative 0%, weak positive 0.4%, positive 17.5%, strong positive 82.1% of 246 HCWs vaccinated with Covishield and were negative 2.8%, weak positive 8.5%, positive 57.1%, strong positive 31.4% of 35 HCWs vaccinated with Sinopharm.
In all HCWs vaccinated with Pfizer Biontech SARS-CoV-2-S-RBD IgG titers were strong positive. Conclusion Humoral immunity was produced in HCWs after two doses of Covishield vaccine 100%, Sinopharm 97.0%, Pfizer Biontech 100% respectively. Antibody titer was higher among younger age workers.

Ancient Mongolia has accumulated experiences from generation to generation and created independent system of body structure, healing and healthy living by developing treatments for illnesses due to long term changes in natural phenomena, extreme climatic conditions, lifestyle habits, habits and war related diseases. The system has become a major part of the culture of Mongolia and has been enhanced by medical knowledge from other countries which include India, Tibet, and Chinese medicine, as well as study of European medicine that has not been sufficiently explored. There has been no research on history when this medical care disseminated in Mongolia and using source in research.
Therefore, this study was conducted to clarify when European medical knowledge arrived in Mongolia, its history and people who made contributions.
Historical facts of when European medicine was first "imported" in Mongolia, were recorded in policy of King Enkh-Amgalan of Manchu Qing Dynasty, the activities of religious missionaries from Europe to Manchuria and Mongolia and documents related to infectious diseases by Russian Consulate in Urguu. Based on these facts, European medical knowledge disseminated in Mongolia from 1703. This knowledge has been slowly spreading as a form of prevention from infectious diseases from the south through Beijing and Inner Mongolia as well as from the north through Buryatia to Ikh Khuree, and in some provinces.

Missed abortion refers to clinical situation in abnormality of early stage of pregnancy. According to WHO study, abnormality of early stage of pregnancy accounts for 15-20% of total pregnancy disorders, moreover missed abortion is about 10-20% of abnormality of early stage of pregnancy. Missed abortion is one of the obstetrical complication, which is caused by several risks and causes, resulting fetal movements stop and aborted in uterus causing clotting defects and bleeding. Under the cases and statistics in capital maternity hospitals during 5 years, 168781 births was registered but 8887 of them were diagnosed with IUGR and were hospitalized, meaning frequency of missed abortion is increasing.470 mothers whom were diagnosed missed abortion at department of “Treatment of preterm pregnancy” and 1000 mothers whom were hospitalized in department of “Treatment of pregnancy disorders” of First Maternity Hospital were included in our study. Retrospective study was used. In prospective study, 50 mothers whom were hospitalizing with diagnosis of missed abortion at department of “Treatment of preterm pregnancy” and 50 mothers whom were going to go under abortion when they had normally developing baby, total 100 mothers were participated in our study.Participants’ age was among 18-43. Average age of case group participants’ was 30.5. Differentiating by age, 31.9% were age of 30-34, and 25.7% were at age of above 35. According to pregnancy frequency, above 4 pregnancy was 34.3% in case group, аabove 6 pregnancy 13% in case group (p=0.01). Defining the duration between pregnancies, the duration of 1 year was 27.7% in case group (p=0.01). Previous abortion accounts for 147 (31.3%) in case group and 116 (11.6%) in control group, meaning there is statistical value in both groups (p>0.05). In case group study, 228 (48.5%) participants had previous abortion, 101 (21.4%) had miscarriage, and 47 (10%) mentioned about missed abortion before. Comparing ultrasound finding in 6-7 weeks of gestational age with last menstruation period, had difference of 2-3 weeks. Moreover, 56% were with-fetus type and it was diagnosed at the 7 weeks of gestational age, and 44% were anembrionic types which were diagnosed in 6 weeks of gestational age. In blood coagulation laboratory test finding; prothrombin time was 32 (8.4%), ACT 60(15.6%), thrombin time was 39(10,2%), fibrinogen 34(8.9%)resulting elongated duration change accounts for most of the cases. Comparing “TORCH” test result in type 1 acute infection, it increase the risk of missed abortion by 3 times (OR=3.579,P=0.005), and type 2 both acute and chronic infection affects the missed abortion occurrence (OR=3.807, P=0.001). In uterus swab test, foam cellinflammation (OR=0.431, P=0.001) and villous destructive change (OR=0.276 P=0.002) had difference of statistical value. The risks of missed abortion are including mothers’ age, pregnancy frequency, duration between pregnancies (P<0.05), previous missed abortion affected pregnancy (OR=5.444, p=0.028) and abortion (OR=1.93,p=0.005). In ultrasound finding 2-3 weeks were delayed. And with-fetus type was 56%, and 44% was non- fetus type. If duration of missed abortion lasts long coagulation factors such as prothrombin time, ACTand thrombin time is elongated making it risky for bleeding. Herpes simplex virus infection and its type and 2, acute and chronic infections are high in case group. In uterus swab test, foam cell inflammation (P=0.001) and chorionic villi inflammation (P=0.002) affects growth restriction.

Missed abortion refers to clinical situation in abnormality of early stage of pregnancy. According to WHO study, abnormality of early stage of pregnancy accounts for 15-20% of total pregnancy disorders, moreover missed abortion is about 10-20% of abnormality of early stage of pregnancy. Missed abortion is one of the obstetrical complication, which is caused by several risks and causes, resulting fetal movements stop and aborted in uterus causing clotting defects and bleeding. Under the cases and statistics in capital maternity hospitals during 5 years, 168781 births was registered but 8887 of them were diagnosed with IUGR and were hospitalized, meaning frequency of missed abortion is increasing.470 mothers whom were diagnosed missed abortion at department of “Treatment of preterm pregnancy” and 1000 mothers whom were hospitalized in department of “Treatment of pregnancy disorders” of First Maternity Hospital were included in our study. Retrospective study was used. In prospective study, 50 mothers whom were hospitalizing with diagnosis of missed abortion at department of “Treatment of preterm pregnancy” and 50 mothers whom were going to go under abortion when they had normally developing baby, total 100 mothers were participated in our study.Participants’ age was among 18-43. Average age of case group participants’ was 30.5. Differentiating by age, 31.9% were age of 30-34, and 25.7% were at age of above 35. According to pregnancy frequency, above 4 pregnancy was 34.3% in case group, аabove 6 pregnancy 13% in case group (p=0.01). Defining the duration between pregnancies, the duration of 1 year was 27.7% in case group (p=0.01). Previous abortion accounts for 147 (31.3%) in case group and 116 (11.6%) in control group, meaning there is statistical value in both groups (p>0.05). In case group study, 228 (48.5%) participants had previous abortion, 101 (21.4%) had miscarriage, and 47 (10%) mentioned about missed abortion before. Comparing ultrasound finding in 6-7 weeks of gestational age with last menstruation period, had difference of 2-3 weeks. Moreover, 56% were with-fetus type and it was diagnosed at the 7 weeks of gestational age, and 44% were anembrionic types which were diagnosed in 6 weeks of gestational age. In blood coagulation laboratory test finding; prothrombin time was 32 (8.4%), ACT 60(15.6%), thrombin time was 39(10,2%), fibrinogen 34(8.9%)resulting elongated duration change accounts for most of the cases. Comparing “TORCH” test result in type 1 acute infection, it increase the risk of missed abortion by 3 times (OR=3.579,P=0.005), and type 2 both acute and chronic infection affects the missed abortion occurrence (OR=3.807, P=0.001). In uterus swab test, foam cellinflammation (OR=0.431, P=0.001) and villous destructive change (OR=0.276 P=0.002) had difference of statistical value. The risks of missed abortion are including mothers’ age, pregnancy frequency, duration between pregnancies (P<0.05), previous missed abortion affected pregnancy (OR=5.444, p=0.028) and abortion (OR=1.93,p=0.005). In ultrasound finding 2-3 weeks were delayed. And with-fetus type was 56%, and 44% was non- fetus type. If duration of missed abortion lasts long coagulation factors such as prothrombin time, ACTand thrombin time is elongated making it risky for bleeding. Herpes simplex virus infection and its type and 2, acute and chronic infections are high in case group. In uterus swab test, foam cell inflammation (P=0.001) and chorionic villi inflammation (P=0.002) affects growth restriction.

Acupuncture and moxibustion are an important component of Traditional Mongolian Medicine with a long history. As early as the new Stone Age in Mongolian territory, primitive human beings used the stone needles, the earliest acupuncture instrument, to treat diseases. The activities of human beings appeared in Mongolian territory about 800000 years ago. We mentioned about the History of Acupuncture and Moxibustion in the chapter one. In this time, I am going to explain how to set up the Sect of Acupuncture and Moxibustion based on some of the Chinese medical books between the end of 17th and the beginning of 18th centuries. Sect of Acupuncture and Moxibustion established through the Great Compendium of Acupuncture and Moxibustion by Yang Ju Zhou (1601), in the end of 17th and the beginning of 18th centuries in the Western part of Mongolia. The 17-18th century, students of Namkhaijamts, Zaya bandida and Oirad have translated as acupuncture and moxibustion books from Chinese into a Mongolian script that is named “Tod (one of the ancient Mongolian letters)”. A collection of acuptuncture books, the rich inheritance of Tod and the Kalmykia nationality also translated in 1997 into Russian and a book was printed titled “Traktati ob igloukalivanii i prijiganii – Scripture on Moxibustion.” In 1648, the great Zaya Bandid created the Mongolian letter “Tod,” and tried to spread it throughout Mongolia with the assistance of his students. They translated many books from Tibetan and also translated some selected acupuncture and moxibustion books from Chinese. From some historical facts, we see Western Mongols willing to be independent and to have their own letters and they tried to develop philosophy and its related sections within their own communities. It should be understood that in 1640, 44 people including Baatar prince, Subeedei king of Khalkh, Guush king of Khoshood aimag, Janjaa khutagt lama and the Great zaya bandid Namkhaijamts met and set the law of Mongol Oirad with regard to to approval rights, province border and power. Translating acupuncture and moxibustion books from Chinese into Mongolian initiated the beginning stage of the development of a new, understanding and theory. First of all, Chinese health development strongly influenced the special position acupuncture occupied. For instance there are some works such as Zheng Zi-He “Ru Men Shi Qin,” 1228, Hua Shou “Shi Si Jing Fa Hui,” 1341, Zhu Zhen-Hen “Dan Xi Xin Fa,” 1347, and “Zhen Jui Da Cheng,” in 1601. It is certain that the educated Mongolians had tried to consider and develop some of these works. Under the Chinese influence a well- known Korean doctor had written a book titled “Eastern health science dictionary,” in the northern part of Korea. This work is the first and most classic book in northern Korea. Even though Buddhism spread strongly in Mongolia, Western Mongols were comprised of many types of nomads with different nationalities and genetics, so their psychology and wisdom is different and people living in this area viewed society from many different perspectives. The academician Ch.Dalai explained the abovementioned matter represented by the great Zaya bandida; “It is very clear from his state and religious leading activities that Zaya bandida viewed everything from a central view and with wide aspects. He knew both theories of a governing state and the religion that great Mongolian kings inherited. Therefore he is a scientific lama who tried to implement both points of view. Unfortunately this health science trend that was based on the above was not developed because of Buddhism that spread strongly in all strata of Mongolian society and was snowed under the Buddhism in Oirad 1 .” Later local research museum officer Sambuu, in Uvs aimag, Mongolia found notes from Grandma Rolmaa or Dulmaa, Uriankhai–etnic group in 1959, and he brought them to the library of literature institute and gave them to Professor B. Rinchin. He took photos and wrote the foreword and printed 500 copies of a text which was titled “Collected notes of acupuncture,” in 1967. In his foreword he said, “Here there are many things to study from the perspective of literature and also the difference of this inherited slang and phrases of “Tod,” letter that was used in literature from Indian and Tibetan literature.” Further he mentioned, “Those two volumes published are related to many aspects, and also present many issues for our scientists and Mongolism researchers.” This book has six volumes (some say 10) but in the above publication it was only printed 4 and 6 volume annotations. Other notes could not be preserved until today.