Background: Musculoskeletal disorders account for 23.1-47.1% of occupational diseases in several countries. Studies have shown that operators of heavy machinery, including tractors and dump trucks, are twice as likely to experience lower back pain compared to workers not exposed to whole-body vibration. Furthermore, research has indicated that acute exposure to vibration can cause vasoconstriction and vascular inflammation. However, limited research has explored the relationship between lower back pain and specific biomarkers, highlighting the need for this study. Aim: This study aimed to compare lower back pain prevalence and muscle inflammation biomarkers among heavy machinery operators. Materials and Methods: A purposive sampling method was used to recruit 15 male participants aged 25-35 years who had worked as heavy machinery drivers for no more than three years. Inclusion criteria were: no alcohol consumption within 24 hours prior to sampling, body mass index (BMI) between 18.5-28.9 kg/m², no prior diagnosis of musculoskeletal disorders, and absence of infectious or non-infectious diseases during the study period. Blood samples were analyzed for Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) levels using enzyme-linked immunosorbent assay (ELISA). Results: The mean BMI of participants was 25.89±3.23 kg/m². Over half (53.3%, n=8) exceeded the exposure limit for whole-body vibration. Low back pain was reported by 13 participants (86.7%) over the past six months and by 12 participants (80%) over the past seven days. TNF-α levels did not differ significantly between groups based on low back pain status or vibration exposure. However, IL-6 levels showed a significant increase 24 hours after whole-body vibration exposure (p=0.027). Conclusion Lower back pain was highly prevalent among participants exposed to whole-body vibration. Furthermore, IL-6 levels were elevated among participants reporting lower back pain, regardless of vibration exposure levels.

Background: According to the 2023 report on global water sector development, water consumption has increased by approximately 1% annually over the past 40 years and is expected to rise further due to population growth, socio-economic development, and changes in consumption patterns. Both low- and middle-income countries face risks related to water quality. In many developing nations in Asia and Africa, natural water sources are of poor quality and lack purification infrastructure, with limited research and data available—often restricted to monitoring reports and basic statistics. Although the United Nations' Sustainable Development Goals (SDG-2030), adopted at the 70th UN General Assembly, aim to ensure access to safe drinking water and sanitation for all, around 26% of the global population—approximately 2 billion people—still lack access to safely managed drinking water services. In line with this, Mongolia’s long-term development policy “Vision-2050” sets a target to ensure 90% of the population has access to safe drinking water by 2030 through comprehensive measures. The World Health Organization (WHO) identified ten key chemical contaminants posing significant public health concerns in 2020, including arsenic, along with air pollution, asbestos, benzene, cadmium, dioxins, excessive fluoride, lead, mercury, and hazardous pesticides. Over 140 million people in more than 70 countries are consuming arsenic-contaminated water, exceeding the WHO guideline of 10 μg/L. While Mongolia has conducted studies on arsenic contamination in drinking water in 2004, 2013, and between 2019–2022, there is still a scarcity of research assessing the potential health risks associated with such contamination. Aim: To assess the health risk of arsenic exposure through drinking water. Materials and Methods: Using a document-based research design, we obtained official permission from the Health Statistics, Information and Research Department (Letter No. 01/290) and collected arsenic testing data and well information from 29 internal research reports. A database was created, and secondary data analysis was conducted. Based on the U.S. Environmental Protection Agency (EPA) methodology, the following were calculated: average daily dose (ADD), lifetime average daily dose (LADD), cancer risk (CR), and hazard quotient (HQ) for arsenic exposure through drinking water. Official statistics from 2023 released by international and national organizations such as the UN, WHO, NSO, MCHD, and NCCD were used for risk calculations. Results: Out of 3,575 drinking water samples collected from 1,315 wells in 329 soums across 21 provinces and 2,260 samples from 9 districts of Ulaanbaatar, 61% met the MNS 0900:2018 national drinking water standard for safety and quality. However, in samples from Dornogovi, Dundgovi, Sukhbaatar, Umnugovi provinces and Nalaikh district, arsenic concentrations exceeded the national and WHO recommended limit (10 μg/L) by 1 to 6 times. Health risk assessment showed hazard quotient values ranging between 0.12 and 1.15. Conclusions Arsenic contamination in drinking water is locally prevalent in the Gobi and Eastern regions of Mongolia (Dundgovi, Sukhbaatar, Dornod, Umnugovi, Dornogovi). The hazard quotient for arsenic exposure via drinking water ranges from 0.12 to 1.15, with 8 provinces showing values above 0.3—indicating potential health risks.

Background: Background: In recent years, ensuring a safe and healthy working environment for mining employees, improving working conditions, protecting and promoting health, and paying attention to other factors affecting health have become essential requirements. While infectious diseases, noncommunicable (chronic) diseases, nutritional disorders, occupational injuries, and mental health conditions are the main indicators for assessing the health impact on mining workers, there is still a lack of research on noncommunicable diseases among mining sector employees in Mongolia. This gap served as the basis for the present study. Aim: To study the risk factors of noncommunicable diseases among employees of Erdenet Mining Corporation Materials and Methods: A total of 303 employees from 15 divisions of Erdenet Mining Corporation participated in the study. Participants belonging to high-risk groups for noncommunicable diseases were selected using a purposive sampling method. The survey questionnaire was developed based on the WHO STEP wise approach to Surveillance (STEPS) of noncommunicable disease risk factors. Results: Of all participants, 70% were male and 30% were female, with an average age of 46 years. The average total duration of employment was 23 years, of which male employees had worked an average of 19.3 years and female employees 17.3 years at Erdenet Mining Corporation. Among participants, 48.5% had never smoked, while 38.3% were current smokers. When analyzing alcohol consumption by job position, it was found that 85.7% of managers and 66.7% of administrative and decoration workers had high levels of alcohol consumption. Regarding physical activity, 23% of male and 15.2% of female employees reported engaging in active exercise more than three days per week, indicating that male employees were more physically active than females. In terms of dietary habits, 28.3% of males and 17.6% of females did not control their salt intake. As for eating patterns, 53.6% of employees regularly had breakfast, 77.3% regularly had lunch, and 76.6% regularly had dinner at a fixed time. Conclusions 1. Among the employees surveyed, 48.5% had never smoked, while 38.3% were current smokers. Daily smoking was most prevalent among employees aged 35–54 years (74.2%), with the 25–34 age group also showing a relatively high rate of smoking. Regarding alcohol consumption, 38.2% of male employees reported drinking vodka or similar alcoholic beverages. Alcohol consumption was significantly higher among males compared to females, indicating that it is a major risk factor for noncommunicable diseases (p=0.003). 2. In terms of dietary patterns, 53.6% of employees reported regularly having breakfast, 77.3% regularly had lunch, and 76.6% regularly had dinner. Eating habits varied by gender. Concerning physical activity, 23% of male employees and 15.2% of female employees engaged in regular exercise, indicating that male employees were more physically active than females. The study found that lifestyle and behavioral factors such as smoking, alcohol consumption, insufficient physical activity, and poor dietary habits contribute to an increased risk of noncommunicable diseases among employees.

Background: Researchers have identified that occupational exposures related to mining operations-such as dust, noise, and vibration—can increase the risk of developing occupational diseases, including pneumoconiosis, hearing loss, and spinal injuries, as well as noncommunicable conditions such as hypertension and cardiovascular diseases. Work-related stress, living away from family, reliance on portable food services, and shift work systems also contribute to weight gain and negatively affect endocrine function. Aim: To investigate the prevalence of metabolic syndrome and noncommunicable diseases among employees of Erdenet Mining Corporation Materials and methods: A total of 303 employees from 15 divisions of Erdenet Mining Corporation participated in the study. Participants included employees with 10–20 years or more of service; 15% were female, and 75% were technical workers. Employees belonging to high-risk groups for noncommunicable diseases were selected using a purposive sampling method. Results: When analyzing body mass index (BMI) by occupation, overweight or obesity was found among 79.2% of service workers, 65% of electricians, 100% of fuel distributors, 77.8% of decorators, 75.5% of mechanics, 94.7% of specialists, 86.4% of professional workers, 75.7% of operators and engineers, and 88.9% of administrative staff. Central obesity was also analyzed by job position, revealing that 79.2% of service workers, 60% of laboratory staff, 35% of electricians, 64.9% of operators and engineers, and 66.7% of administrative employees had central obesity. Among all participants, 20.7% had a previous history of cardiovascular disease, of whom 71.4% were male and 28.6% were female. The mean blood glucose level among participants was 6.0 mmol/L, with a median of 5.6 mmol/L, a minimum of 3.9 mmol/L, and a maximum of 18.3 mmol/L. The median glucose level was 0.2 mmol/L lower than the national average. No statistically significant difference in blood glucose levels was found between males and females (p = 0.135). By job position, elevated blood glucose levels (prediabetic range) were found in 62.5% of service workers, 40% of laboratory staff, 35% of electricians, 71.4% of managers, and 55.6% of administrative employees. Conclusion The findings indicate an increasing trend in metabolic and cardiovascular risk factors among employees of Erdenet Mining Corporation SOE.

Background: Stroke is one of the leading causes of mortality and disability worldwide. Understanding sex differences in risk factors, clinical characteristics and death after stroke might provide valuable evidence for prevention and management of stroke. Aim: We aimed to describe sex differences in risk factors, clinical characteristics and death after intracerebral hemorrhage (ICH) and ischemic stroke (IS) using hospital-based registry in 6 districts of Ulaanbaatar, Mongolia. Materials and methods: We used hospital-based stroke registry in Ulaanbaatar Mongolia. From 2019 to 2020, total of 974 patients with acute ICH and 1612 patients with acute IS were enrolled in this study. The severity of stroke was measured by National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS). Risk factors for stroke were defined as patient’s history and their medical record. Death after stroke was registered at 28 days and 90 days by follow-up study. A comparison of categorical and continuous variables was analyzed using chi-squared test, Student’s t-test and Mann Whitney U test. Univariable and multivariable logistic regression analyses were also performed. Results: The mean age of ICH patients was 58.41±11.56. There was significant difference in age (59 vs 57, p=0.009) between women and men. Men with ICH were more likely to drink alcohol (35.4% vs 5.2%, p=0.000) and to smoke (37.0% vs 8.4%, p=0.000) and to have arterial hypertension (72.7% vs 58.6%, p=0.000). However, there were no significant differences in other risk factors including atrial fibrillation, diabetes mellitus, prior stroke and other cardiac diseases. There were no sex differences in clinical characteristics including systole and diastole blood pressure, NIHSS scores and GCS. In our study, case fatality rate was 23.8% at 28 days and 1.9% at 90 days after ICH. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.74; 95% CI:0.52-1.06, OR: 0.80; 95% CI:0.29-2.21).
The mean age of IS patients was 61.07±12.88. The women were older (63 vs 59, p=0.000) than men. Men with IS also were more likely to be current smokers (37.6% vs 9.0%, p=0.000), current drinkers (33.2% vs 3.4%, p=0.000) and to have arterial hypertension (74.7% vs 65.9%, p=0.000). There were no significant differences in other risk factors. For IS patients, there also was no sex difference in clinical characteristics. Case fatality rate was 13.3% at 28 days and 1.1% at 90 days after IS. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.90; 95%CI: 0.64-1.26, OR:5.16; 95%CI: 0.99-23.9). Conclusion Our study showed sex differences in some vascular factors of both stroke subtypes which emphasized that we need to implement stroke prevention targeting sex-specific risk factors. While clinical characteristics and early mortality of intracerebral hemorrhage and ischemic stroke were not differed by gender.

Background: The American Heart Association estimates that more than 1 million people die each year from acute coronary heart disease and half a million from acute coronary syndrome, and that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health Organization, 2013]. Goal: In this study we aimed to using coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease. Material and methods: From 2018 to 2021, we performed a coronary computed tomography angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT) device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central Hospital.
Common statistical measurements such as means and standard errors were calculated. Probability of results were checked using Student’s test. Result: In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable plaques in coronary artery disease that coronary artery diameters more widening to compared healthy artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18 (38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5). Conclusion We detect that computed tomography angiography (CCTA)’s specific signs of unstable plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes and rupture of intima.

Background: Globally the incidence of stroke is not decreasing, and the deaths and disabilities caused by stroke is increasing every year, especially in low and low-middle income countries.
Long-term trends in stroke incidence in different populations have not been well characterized, largely as a result of the complexities associated with population-based stroke surveillance.
Having reliable data on stroke morbidity and mortality, as well as periodic identification of long-term trends will be important information for proper prevention planning in the population, monitoring the disease and further improving the quality of health care. Material and Method: A prospective cohort study has been conducted in adult citizens (972409 in 2019, 925367 in 2020) of 6 districts of Ulaanbaatar from the 1st of January, 2019 to 31st of December, 2020. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and some private hospitals. Information of stroke death was obtained from forensic institute and state registration office of the capital city.
The trends of stroke incidence and mortality was compared to data between 1998-1999 and 2019- 2020 in UB. Results: The age-standardized crude incidence rate per 100.000 person-years of stroke were 209.0/100.000 (n=1934) in 2019 and 194.0/100.000 (n=1821) in 2020 among adults of UB city. The above results were compared to 1998-1999 studies and the incidence rate declined by 94.0/100.000 in 2019-2020, whereas mortality rate increased by 10.0/100.000 in women aged 16-34. Stroke mortality was 11.6% in 1998 and 26.5% in 1999, while in our study it was 33.87% in 2019 and 29.71% in 2020. Although the incidence of stroke rates has decreased in 1998-1999, the mortality rate has not decreased significantly. Conclusion Morbidity and mortality rates among the population of Ulaanbaatar citizen remain highest in the world, compared to 20 years ago with overall morbidity declining but mortality has not decreased.
In recent years, the Government of Mongolia has been focused on reducing non-communicable diseases, but the primary and secondary prevention and control of stroke in the general population, as well as the acquisition of knowledge attitudes, practices and access to health care still need to be improved.

Background: Stroke is still one of the leading causes of morbidity and mortality worldwide. Registry-based data of stroke are scarce in low and middle-income countries such as Mongolia. We aimed to investigate the incidence and mortality of stroke in adult population of UB Mongolia by stroke registration method. Material and Method: Covering 611265 (≥15 years old) adult citizens of three districts of Ulaanbaatar, a population-based prospective study was done from the first, January of 2019 to 31st, December of 2019. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and family clinics. Information of stroke death was obtained from forensic institute and state registration office of the capital city. Results : In a 1-year study period, 1068 (women 39.1%) stroke cases were registered in people with 60.16±13.66 years old. Stroke incidence rate was 169.81/100000 including first-ever and recurrent events. Stroke incidence rate was higher in men and people with 80 and above years old. The ratio between IS and ICH was 1.14:1.0. Stroke mortality was 27.1% and mortality rate was 45.94/100000. The highest rate mortality was in ICH subtype, male population and older people. Conclusion We identified relatively high incidence and mortality rate of stroke in ICH indicating an urgent need for improvement of arterial hypertension control, health education and primary prevention mainly among men.

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.

In terms of mortality and morbidity and disability burns are emerging as a major child health problem in Mongolia. This trend is similar to many other developing and low incoming countries. To develop effective burn prevention programmes, information on its prevalence and etiology are necessary. To describe the epidemiology of child burns in UB, identify the trends of burn occurrence, the vulnerable population and etiology. Descriptive statistic and one-way analysis of variance were employed. The study was carried out to analyze the prevalence, mortality and current etiology of pediatrics burns in Ulaanbaatar during 10 years (2004-2013). The overall incidence rates of death were 26.3 per 100000 person-years. The male-to-female ration of incidence rate for children younger than 5 years was 1.1. There was also significantcorrelation between age groups and aetiology of burns.(P<0.0001). Analyses showed that younger children were more vulnerable to scald injury. The etiological subgroups of scalding were scalding with hot drinks/food and scalding with hot water meant for household. Flame was the most common etiology of burn for children up of 5 years and almost all other age groups.