Background: According to the World Health Organization (WHO), approximately 2,000 types of congenital anomalies affecting the human body have been identified, among which craniofacial anomalies rank between second and fourth in prevalence. Hearing impairment occurs in approximately 1.62 per 1,000 live births, while congenital malformations of the external and middle ear occur in about 1.6 per 10,000 live births. The WHO epidemiological report (2022) indicates that severe combined congenital malformations of the external and middle ear, including microtia and aural atresia, occur in approximately 2.35–7 per 10,000 live births. The prevalence of microtia is relatively higher in certain regions of Asia and South America (1 per 1,500–3,000 live births), whereas lower rates have been reported in Europe and Africa. Aim: To evaluate the feasibility and outcomes of surgical reconstruction of the auricle and the external auditory canal–tympanic cavity (meatotympanoplasty) in patients with combined congenital malformations of the external and middle ear. Materials and Methods: Audiological evaluation revealed an air conduction hearing loss of 75–80 dB. Computed tomography grading showed scores of 5–6, corresponding to grade III congenital malformation of the external and middle ear, and classified as type III according to the Nagata–Weerda classification.In cases of unilateral combined congenital external and middle ear malformations (auricular deformity with associated aural atresia), auricular reconstruction and external auditory canal formation were performed in two surgical stages with a 6-month interval. At postoperative day 21, removal of the external auditory canal stent revealed no evidence of canal stenosis, and epithelialization of the skin graft had begun. Result: Postoperative audiological assessments conducted at 30, 45, and 60 days demonstrated a statistically and clinically significant improvement in hearing thresholds, which correlated directly with the healing status of the newly reconstructed tympanic membrane. Conclusion The findings of this study suggest that in patients with combined congenital malformations of the external and middle ear, simultaneous reconstruction of the auricle and the external auditory canal–tympanic cavity in a single surgical stage may be feasible. This approach has the potential to reduce overall treatment duration, surgical burden, and psychological stress for patients. However, further studies involving larger patient cohorts and long-term follow-up are required to evaluate hearing stability and the incidence of postoperative complications, including restenosis and secondary tympanic membrane changes.

Background: According to global estimates, one in seven adolescents aged 10–19 (14%) experiences mental health issues, most of which remain undiagnosed and untreated. Self-esteem is closely associated with adolescent mental health, affecting their academic performance, relationships, and emotional well-being. Objective: This study aimed to assess the self-esteem levels of middle school students using Rosenberg's Self-Esteem scale (RSES). Material and Methods: A cross-sectional study was conducted among 154 students from grades 6 to 9 in a general education school in Ulaanbaatar. The Rosenberg’s Self-Esteem scale which has a standard mean score of approximately 22, was used for assessment. Scores below ≤14 indicate low self-esteem, scores between 15–25 indicate average self-esteem, scores under ≥26 indicate high self-esteem. The Ethics committee of the University of Sociology and Psychology approved this study. Data were analyzed using Microsoft Excel and SPSS-23, applying frequencies, descriptive statistics, chi-square tests, one-sample T-tests to compare the mean score with the standard value, one-way ANOVA to examine differences between groups, and correlation analysis. Statistical significance was considered at p≤0.05. Results: The students mean self-esteem score was 17.8 (SD±4.42), significantly lower than the standard score of 22 (p<0.001), supporting our hypothesis. Statistically significant differences in self-esteem were found between grades 6, 8, and 9 (p<0.05), while no significant differences were observed by gender or age (p>0.05). Among the participants, 24.7% (n=38) had low self-esteem (score ≤14), 72.1% (n=111) had average self-esteem (scores 15–25), and only 3.2% (n=5) demonstrated high self-esteem (score ≥26). Conclusion The self-esteem of middle school students was significantly lower than the standard average. Nearly one in four students demonstrated low self-esteem, suggesting the need for early interventions to support the mental well-being of adolescents.

Background: Spine diseases, back pain, curvature, and intervertebral disorders are increasing among the population of Mongolia. According to a study of diseases covering 195 countries of the world in 1990-2016, spine disease ranked third among non-communicable diseases. However, at present, very little research has been done on the prevalence of spinal diseases among the population of Mongolia. Research goal: Detecting the location of spinal pain in patients with back pain, curvature and other pains who visited “Altanmed” hospital. Research methods: The study was conducted in a hospital setting using a snapshot survey method. From January 1, 2021, to January 1, 2022, a total of 2,210 patients were examined and treated at “Altanmed” hospital, of which 560 therapists were randomly selected from patients over 18 years old and participated in the study. Subjects were asked to complete a questionnaire and rate their pain on a 0-10 scale. Conclusion
1. 69.8% (n=391) of 560 patients who came to “Altanmed” hospital with back pain were lumbar and lower back pain.
2. 74.4% (n=291) or the majority has lumbar and lower back pain among patients aged 31-50. Of the 391 clients with lower back pain, 11.5% or 45 had mild (pain score 1-3), 52.9% (n=207) moderate (pain score 4-6), and 35.5% (n=139) severe pain (pain score 7-10), and the groups differ with statistical probability (p<0.01).
3. Regarding the duration of pain, 8.4% (n=33) had acute pain up to the last 3 months, and the remaining 91.6% had chronic back pain. The average pain scale was 5.76 (SD±1.8).

Result the subtypes and effectiveness of functional endoscopic sinus surgery(FESS) using a microdebrider Introduction: Chronic rhinitis in children has been on the rise in recent years, and polyps account for the majority of benign nasal cancers in children. Surgery is necessary when drug treatment is ineffective. We use pediatric rhinoplasty. Aimed at calculating the subtypes and effectiveness of Functional endoscopic sinus surgery(FESS) using a microdebrider. Material and methods: The survey was conducted between March and April 2020, based on the Otolaryngology Surgery Department of the National Center for Maternal and Child Health, using the cross-section of analytical design under Objectives 1 and 2 and the longitudinal design under Objective 3. Under Objectives 1 and 2, participants' information was collected from a pre-prepared questionnaire from their medical history. The questionnaire has four chapters that provide general information about the patient, clinical signs, surgical structure, and biopsy results. The pain was assessed by the “Sino-Nasal Outcome Test (SNOT-20)”. A total of 98 patients were included in the statistical analysis of the survey results using the STATA 15.0 program, and the results of the surgery were evaluated by 20 patients. Results: In children with chronic rhinitis, the SNOT20 test showed a statistically significant difference of 1.6 ± 0.6 before surgery and an average of 0.51 ± 0.11 after surgery. Conclusion: In chronic rhinitis, FESS with microdebrider surgery is an effective treatment for children.

Background: The career and work of medical workers are considered to be the occupation of the highly responsible job of the worldwide. Goal: To identify the percentage of the work-related stress, the burnout, and the symptoms of work-related stress of the physicians and nurses who is working at the critical and intensive care units of UB hospitals. Materials and methodology: The survey was done by quantitative methods and cross sectional design. The study data was collected using the validated questionnaire for the work related stress. The results of the study were analyzed by the Microsoft Excel and SPSS 20 program. Results The response rate was 97.3% The study found that 78.7% of respondents reported having regular stress; and 89.4% of all participants in the survey had a personal burnout, 90.4% had work-related burnout and 94.5% had a high level of client-related burnout.
Physical symptoms include the insomnia 76.7%; psychological symptoms - the headaches 65%; behavioral symptoms as like forgetfulness and annoyance 53.3%; cognitive symptoms as like an increase in sick days or absenteeism by 40% for all physicians and nurses.

Background: Some findings of an artifacts have revealed that nature based the raw have been used for the treatment of mankind's diseases over 60 000 years ago. WHO estimates that about 80 percentage of the world's population are consume the traditional medical care, and uses more than 21,000 plant species for therapeutic purposes. In order to help guide its member countries the World Health Organization (WHO) has developed The WHO Traditional Medicine Strategy 2014-2023. Some of the strategic actions in this document include:
• To develop and share appropriate research methodologies and criteria for evaluating the safety, efficacy, and quality of TM (Traditional Medicine) products;
• To study and explain the disease prevention, health maintenance, the diagnosis and the treatment of the TM disease according to the evidence based scientific studies. Objectives: to determine the most frequently used medicinal plants for the treatment of "Rlung" in the TM. Methods: The comparison method, the synthesis and analysis method, the induction and deduction method, the listing and sorting method, the inspecting and arrange method, and the methods of documents' drafting were used in this study. Results: It is shown that over 80 raw materials of plant, mineral and animal origins has to list within 32 drug recipes which used "Rlung" disease of TM. The first five raw materials from these 80 ingredients have been repeatedly lists zadi - 30, agar (black, white, red agar) -19, arur-19, lish -18, and nin shosh -18 times. Conclusion The most frequently used the raw materialin the treatment of "Rlung" diseases is the seeds of Myristica fragrans Houtt. which contains a lot of the saturated acids with membrane-enhancing effects and strong antioxidant substances.

BACKGROUND. Sensorineural hearing impairment (SNHI) is the most common inherited sensory defect, affecting about 3 per 1000 children. More than 50% of these patients have a genetic cause (i.e. hereditary hearing impairment; HHI). Mutations in certain genes were noted to be extraordinarily popular in the deaf patients across different populations, making molecular screening feasible for these common deafness genes. One of the most important characteristics that we have learned concerning hereditary hearing loss is that common deafness genes and their mutations are usually different according to the ethnic background. As demonstrated in our previous studies performed in Taiwanese patients, the mutation spectrums of common deafness genes, such as the GJB2 gene and the SLC26A4 gene, are different from those in the Caucasian or even other Asian populations. These findings further underscore the indispensability of the collection of local data in terms of genetic counseling. In the collaborative project, we have successfully established a cohort of >100 hearingimpaired families, and clarified the genetic epidemiology of deafness in the Mongolian population. We identified several special deafness mutations such as GJB2 c.23+1G>A, c.559_604dup, and SLC26A4 c.919-2A>G, and our results revealed that Mongolian patients demonstrate a unique genetic profile in deafness as compared to other East Asian populations (paper in preparation). Meanwhile, by organizing a seminar at National Taiwan University Hospital in March 2017, we have transferred crucial concepts and techniques regarding how to perform genetic testing for deafness to the Mongolian colleagues. In the future, we plan to strengthen the mutual collaboration by expanding the clinical cohort and upgrading the genetic examination platform using the NGS techniques.

Background: Headache disorders are most prevalent public-health problem. Worldwide, among the adults 46% suffer from primary headache, where the migraine presents 11% and tension type headache (TTH) presents 25%. Recently, one type of the primary headache, medication overuse headache tends to increase. Nowadays, there is no sufficient study about primary headache in Mongolia. So that, it is necessary to investigate prevalence, clinical type and risk factors of the primary headache. Purpose: To study prevalence and risk factors of primary headache in Mongolia. Materials and Methods: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old were randomly selected from four provinces and three districts of Ulaanbaatar city. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program. Results: A total of 2043 participants (812 men and 1231 women) were reviewed. The participant’s average age was 38.6±13.4years. 1350 (66.1%) participants reported recurrent headache within the last 1 year. Of the total study population, the prevalence rate of primary headache was 1305 (63.9%). Number of people who suffered from migraine was 494 (24.2%), significantly greater in female than male participants (p=0.0001), with most frequent attacks at age 26-45 years. The risk of migraine associated with sex, education and family history (p=0.001). 592 (29.0%) of participants had TTH, mean age of them was 37.7±5.24, significant high rate in female than men, risk of TTH depends on education and job. The medication overuse headache was diagnosed at 116 (5.7%), 29.4% in men and 70.5% in women with average of 45.6±11.4 and 43±12.7 respectively. Among the participants 38.6% used medications, 28% people had one drug, 8.5% two drugs and 2% used three or more drugs. Use of non-steroid anti-inflammatory drugs (NSAID) made up major percent in headache patients. Increased frequency of medication and multidrug affected to medication overuse headache (p=0.008). Conclusion More than half of studied population had primary headache. Migraine was in 24.2%, TTH in 29.0% of people, and associated with sex, education and family history. Use of non-steroid anti-inflammatory drugs made up major percent in headache patients.

Background: The basics of the development of the Traditional Medicine (TM) in the XXI century are to study medical books created by physicians of the early period; and need to scientific - based understanding the concepts in those scripts. Goals: To investigate the physical properties and the composition of saturated and unsaturated fatty acids (FA) sesame oil which used the symptoms of the wind humor root diseases (the symbolic terminology in TM) comparing with some vegetable oils or seed oils. Materials and methods: We are used “The Instruction Tantra” of “The Quintessence Tantras”, “The Golden Decoration” (གསེར་རྒྱན།) of Darma maaramba Luvsanchoidog which is the explanation scripts of “The Instruction Tantra”. The research was conducted through the method of original manuscript analysis, the comparison method, induction and deduction method. Results: The sesame oil has the saturated FA (14.2%) and unsaturated FA (81.4%) and which approximately amount with the olive oil (13.8%; 83.5%), sunflower oil (9.7%; 87.4%), corn oil (12.9%; 82.3%), soybean oil (15.6%; 80.5%). Conclusions Sesame oil has saturated (14.2%) and unsaturated fatty acids (81.4%); and has been used for the treatment of wind humor such as light, mobile, non-oily, cool nature – external characteristics of body in Ancient Indian Ayurvedic Medicine. We can be substitute olive oil, sunflower oil, corn oil, soybean oil which have rich of the amount of unsaturated FA (especially high level of mono and poly unsaturated FA) instead of the sesame oil in the treatment.

BACKGROUND. Sensorineural hearing impairment (SNHI) is the most common inherited sensory defect, affecting about 3 per 1000 children. More than 50% of these patients have a genetic cause (i.e. hereditary hearing impairment; HHI). Mutations in certain genes were noted to be extraordinarily popular in the deaf patients across different populations, making molecular screening feasible for these common deafness genes. One of the most important characteristics that we have learned concerning hereditary hearing loss is that common deafness genes and their mutations are usually different according to the ethnic background. As demonstrated in our previous studies performed in Taiwanese patients, the mutation spectrums of common deafness genes, such as the GJB2 gene and the SLC26A4 gene, are different from those in the Caucasian or even other Asian populations. These findings further underscore the indispensability of the collection of local data in terms of genetic counseling. In the collaborative project, we have successfully established a cohort of >100 hearing-impaired families, and clarified the genetic epidemiology of deafness in the Mongolian population. We identified several special deafness mutations such as GJB2 c.23+1G>A, c.559_604dup, and SLC26A4 c.919-2A>G, and our results revealed that Mongolian patients demonstrate a unique genetic profile in deafness as compared to other East Asian populations (paper in preparation). Meanwhile, by organizing a seminar at National Taiwan University Hospital in March 2017, we have transferred crucial concepts and techniques regarding how to perform genetic testing for deafness to the Mongolian colleagues. In the future, we plan to strengthen the mutual collaboration by expanding the clinical cohort and upgrading the genetic examination platform using the NGS techniques.