Background: In recent years, due to the rapid development of digital technology and the decline in physical activity, there has been a noticeable decrease in the physical development of children and adolescents, along with an increased risk of non-communicable diseases. Organizations such as the World Health Organization, UNESCO, and the International Olympic Committee recommend integrating regular physical activity into daily life to promote population health. Therapeutic physical exercise is an effective method for restoring bodily functions, increasing muscle strength, and correcting movement impairments, and it serves as an important tool for supporting the physical development and health of school-aged children. Therefore, this study aimed to determine the effects of therapeutic physical exercise on the physical development indicators of children with chronic illnesses and disabilities. Aim: To determine the impact and effectiveness of inclusive participation of students with pathological conditions in physical education classes on their physical development and health indicators. Materials and Methods: Thirty students diagnosed with chronic diseases and enrolled in general education schools participated voluntarily. At the beginning of the study, demographic information was collected, and baseline measurements were taken to assess flexibility, waist and hip circumference, forearm and back muscle strength. Therapeutic exercises tailored to the characteristics of each condition were then implemented according to the FITT principle. After the intervention period, follow-up measurements were conducted. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Pearson correlation, and Cohen’s d in SPSS 25.0 software. Statistical significance was evaluated at the p<0.05 level. Results: After the therapeutic exercise intervention, participants’ flexibility increased by 3.70 cm, right-hand muscle strength by 7.50 kg, left-hand muscle strength by 6.92 kg, and back muscle strength by 17.60 kg, all of which were statistically significant changes (p<0.05). Height increased by 2.36 cm and weight by 1.98 kg. The effect sizes of these indicators ranged from moderate to high. Conclusions 1. The results of this study demonstrate that therapeutic exercise may produce statistically significant positive changes in certain physical fitness parameters among students with pathological conditions, particularly in upper limb and back muscle strength, as well as flexibility. The observed effect sizes ranged from moderate to high, indicating potential practical significance for implementation in practice. 2. In contrast, the changes observed in height and body weight are considered to reflect the indirect effects of therapeutic exercise together with the participants’ natural physiological growth and development. 3. This study suggests that therapeutic exercise may serve as an effective approach for promoting inclusive participation in educational activities among students who are exempted from regular physical education classes, while also supporting the improvement of their physical capacity.

Background: The purpose of this study is to evaluate serum creatinine as a marker of estimated glomerular filtration rate (eGFR) in alcohol use disorder people, and to determine correlation between mean arterial pressure (MAP) and eGFR in chronic kidney disease classification level. Methods: In this study, 118 people were examined 2024. We measured serum creatinine based GFR using the Cockroft Gault formula. Biochemical analysis and serum creatinine were evaluated using a fully automatic analyzer (GOLSITE, China). Statistical results were analyzed SPSS. Result: The mean subject age was 48.6±10.3, BMI 25.3±3.7 and male: female ratio was 5:1. Mean arterial pressure was 104±12.8 mmHg, eGFR 94±28 ml/ min/1.73m2, and mean arterial pressure was significantly correlated with estimated glomerular filtration rate (P<0.05) and no difference between male and female recipients. Mean eGFR was calculated into 4 groups of 10-year intervals, that eGFR was decreased significantly with age groups. For the alcohol dependence stages of the Michigan Test, the mean eGFR was stage 1 is 112 ml/min/1.73m2, stage 2 is 89 ml/min/1.73m2, stage 3 is 97 ml/min/1.73m2 and there is not statistically significant correlation between Michigan test scores and eGFR. Conclusion According to our research, one of the optimal methods for assessing kidney function is the creatinine-based CKD calculation method, and long-term excessive alcohol consumption is a risk factor for CKD, as well as one of the main causes of death due to hypertension and cardiovascular disease.

Background: To evaluate changes in liver function in patients with alcohol use disorder and propose preventive measures. Methods: In this study, 118 people were examined between January 2024 to December 2024. Results were analyzed SPSS. Result: The mean subject age was 48.6± 10.3 years, male: female ratio was 5:1. Mean arterial pressure was 104±12.8 mmHg, ALT 86.7 ± 93.8 (U/L), AST 89.3±82.8 (U/L), GGT 213.8±252.3 (U/L). A statistically significant correlation was found between AST and ALT levels (R² = 0.562). However, no significant correlation was observed between body mass index (BMI) and blood glucose levels (R² = 0.002). The AST/ALT ratio was also statistically significant (p = 0.0001). Conclusion Excessive alcohol consumption increases the levels of liver enzymes AST 89.3 ± 82.8 (U/L), ALT 86.7 ± 93.8 (U/L), and GGT 213.8 ± 252.3 (U/L), leading to increased liver cell damage. Therefore, it is necessary to reduce alcohol consumption and implement preventive measures.

Background: Vulnerable populations at risk of micronutrient deficiencies include children and women, especially pregnant women, lactating mothers, infants and young children. According to WHO guidelines, a population with a micronutrient (vitamin and mineral) deficiency of more than 20% is considered a public health problem.
Although Mongolia has made significant progress in improving the nutritional status of the population, especially children and women, the 2024 VI survey found that micronutrient deficiencies are high among pregnant women.
The MMS (Multi-ingredient Micronutrient Supplement) distributed to pregnant women by soum and household health centers contains all the essential vitamins and minerals for pregnant women, but coverage has remained inadequate for more than 10 years. Goal: To establish the prevalence of micronutrients deficiency in pregnant women Materials and Methods: Totally 2796 pregnant women included in cross-sectional study from urban and rural area. Survey procedures consisted of interview, anthropometric measurements, clinical examinations, and the collection of biological (blood and urine) samples for pregnant women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin, soluble transferrin receptor (sTfR), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration. Statistical processing : The data from the survey questionnaires were entered into a database created in the “EpiData 3.1” software environment. The data created and verified in the EpiData software environment were converted to the “SPSS–25” program, and statistical analysis was also performed using the SPSS-25 program. The results table was prepared using Microsoft Word 2021 and Microsoft Excel 2021 programs. Research ethics: The research methodology was discussed at the meeting of the Medical Ethics Review Committee under the Ministry of Health on 2023.03.27 (23/017), and permission to conduct the study was obtained Result : The prevalence of anemia, as measured by hemoglobin, was 22.3% and the iron deficiency anemia (IDA), as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was (39.8%/9.0%). Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 41.9% and lowest in Khangai region 40.2% (P<0.01). The prevalence of vitamin D deficiency among pregnant women was high at 92.5%, and 7.5% of all pregnant women had adequate vitamin D status. The median concentration of 76.4µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l. Conclusions 1. 22.3 percent of pregnant women are anemic, and the prevalence of anemia has not decreased from 2017 levels and remains common.
2. The prevalence of iron deficiency (as measured by ferritin levels) was 39.8 μg/L and the soluble transferrin receptor level was 9.0 μg/L, which is higher than previous studies.
3. The prevalence of vitamin D deficiency among pregnant women remains common, with 76.6% having severe or moderate deficiency, and 15.9% having mild deficiency.

Background: Iron is an essential mineral needed for physical and cognitive development with iron needs greatest during pregnancy, infancy, childhood, and adolescence. Iron is vital throughout the lifespan as it is a component of haemoglobin, the protein responsible for transporting oxygen from the lungs to body cells for energy production. Iron deficiency results from a depletion of body iron stores due to increased iron needs, inadequate dietary iron intake, reduced iron absorption, or loss of iron from infections caused by malaria, hookworms, and other intestinal parasites. In advanced stages, iron deficiency leads to iron deficiency anaemia, a condition of low red blood cells and reduced oxygen-carrying capacity. Goal: This study aimed to determine body iron stores in Mongolian children aged 6-59 months, and estimate prevalence of iron deficiency among of studied children. Materials and Methods: In this study were used materials that collected during the fifth national nutrition survey conducted in 21 provinces of 4 economic regions and 8 districts of Ulaanbaatar city of Mongolia. The fifth national nutrition survey was household based survey; therefore sampling unit was household with 5 year-old child. We had used demographic information collected by interview methods and laboratory examination results on ferritin, soluble transferrin (sTfR), C reactive protein (CRP) and α1-acid glycoprotein (AFP) in serum samples collected from 6 to 59 months old children, pregnant women and 15–49 year-old men living in child’s households. Serum Ferritin and soluble transferrin (sTfR) were used as a biomarker for iron store and iron deficiency and C reactive protein (CRP) and AFG were used as indicators for acute and chronic infection. The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. Effects of C reactive protein (CRP) and AGP concentrations on estimates of ID according to serum ferritin (SF) and soluble transferrin receptor (sTfR) were considered in the study. Ethical considerations : The survey protocol was discussed at the scientific committee of the Public health institute and approved by director of scientific committee of PHI on June 28, 2016. Ethical approval for conducting the survey, including obtaining biological samples was obtained from the Medical ethics committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent was obtained from each participants and adult caregivers of under 5 year-old children. Results: Biomarkers of iron status were adjusted with inflammation indicators and estimated iron deficiency (ID) and total body iron store in 1732 children 6-59 month-olds. The study findings showed that adjusted mean concentration of serum ferritin and soluble transferrin receptor was 33.7 µg/l and 8.8 mg/l in children age of 6-59 months, respectively. The calculated total body iron store by using adjusted SF and soluble transferrin receptor was 2.8 mg/kg among surveyed children. Iron deficiency was estimated by using 2 different biomarkers among selected population group. The prevalence of iron deficiency estimated by using SF was 20.7% in children 6-59 months. Iron deficiency in children defined by using serum soluble transferrin receptor was 27.7%. Conclusions
1. The average serum ferritin and soluble transferrin receptor concentrations was 33.7 µg/l and 8.8 mg/l in children age of 6-59 months, respectively. Total body iron store estimated by using SF and soluble transferrin was 2.8 mg/kg among surveyed children.
2. The prevalence of iron deficiency estimated by using SF and sTfR was 20.7% and 27.7% in children 6-59 months, respectively. According to the WHO recommendation, prevalence of iron deficiency among Mongolian children aged 6-59 months is classified as “prevalent”.
3. Overall proportion of children with low body iron store was 22.4%. The prevalence of iron depletion is relatively common in boys, young children aged 6–23 months, and rural children aged 6-59 months.

Background : Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in dietary patterns and nutrition status, target populations were stratified into 5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary information collected by interview methods and anthropometric measurement results were used in this study. Ethical considerations: The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted by order of director of Scientific committee of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent were obtained from adult caregivers of each children. Results: Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only 8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD) was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%) compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher prevalence of overweight than older children. Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed significant differences between living area and regions. Proportion of the school children 6-11 years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.

Background: Chemotherapy-related acute exacerbation or hepatitis flares related to HCV positive B cell non-Hodgkin’s lymphoma (B-NHL) is one of the significant clinical issues Material and Method: We studied anti-HCV incidences among patients newly diagnosed with B-NHL, from 2015 to 2018. Survey data were collecting from medical history, electronic medical record system of First Central Hospital was acquired and collected according to the research ethics (approved by Ethics Committee of Ministry of Health, No.4 on June 19, 2017). Also, cases of chemotherapy-related acute exacerbation (AE) for HCV-RNA positive cases were studied. Student’s t-test or nonparametric statistics were utilized to test for statistically significant differences in continuous variables, whereas the chi-square or Fisher’s exact test was used for categorical variables. p<0.05 was considered statistically significant. Results: The study showed that 39.5% of 233 cases with B-NHL are anti-HCV positive. Anti-HCV positive prevalence among B-NHL subjects was significantly higher compared to the general population. Chemotherapy-related AE occurred in 21.05% for the anti-HCV positive group and 36.36% for HCV-RNA positive group. Furthermore, before chemotherapy alanine aminotransferase (ALT) median was 15.2 for the group without AE, whereas it was 48.2 for the group with AE (p<0.01). Conclusions Our study showed that the prevalence of anti-HCV positive among B-NHL patients was significantly higher than the general population prevalence. For all cases of AE, HCV-RNA was positive, and these patients were treated with only chemotherapy without any anti-viral treatment. Anti-viral therapy needs to be introduced urgently to prevent AE since liver fibrosis is aggravated quickly after AE.

Background: In order to study and evaluate the nutrition situation of the Mongolian people. The 2016-2017 NNS V includes 5 different age groups from Mongolian’s four economic development regions and Ulaanbaatar. The NNS V survey quantifies the prevalence of the nutrition conditions that are of greatest concern to the population, particularly young children and pregnant women. Goal: To establish the prevalence of micronutrients deficiency and estimate micronutrient intake in pregnant women Materials and Methods: Totally 2220 pregnant women included in cross-sectional study from urban and rural area. Survey procedures consisted of interview, anthropometric measurements, clinical examinations, and the collection of biological (blood and urine) samples for pregnant women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration. Result: The prevalence of anemia, as measured by hemoglobin, was 21.4% and the iron deficiency anemia (IDA) was 10.5%, as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was 29.6%.
Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 35.1% and lowest in Eastern region 21.5% (P<0.01). The prevalence of vitamin D in pregnant women was high with 75.4% and 4.4% of all pregnant women had sufficient vitamin D status. An additional 20.2% of pregnant women having insufficient levels. The median concentration of 120.5µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l. Conclusion
1. One in every 5 pregnant women (21.4%) is anemic.
2. Vitamin D intake among pregnant women (7.3%) is very low, with 75.4% having vitamin D deficiency and vitamin D insufficiency –by 20.2%.
3. Median urinary iodine concentration of pregnant women is 120.2mg/l, considerably lower than WHO recommended reference range, indicating pregnant women are at risk of iodine deficiency.
4. Despite visible growth in vitamin and mineral supplements intake by pregnant women, compared to 2010, the infrequency of intake and failure to consume recommended number of supplements as instructed in the relevant guides persist.

Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.

IntroductionAfter discovering an important biological function of selenium, selenium content and its deficiency arestarted to be extensively studied in numerous epidemiological studies that have been conducted inmany countries in the world. In Mongolia, as a country geographically located in unstable climate zone,there are no studies conducted on selenium so far since the last century, except one study determiningselenium deficiency signs in livestock.GoalTo determine selenium (Se) content in Mongolian wheat and livestock meatMaterials and MethodsIn total 30 samples of wheat planted in Dornod, Uvs, Tuv and Selenge aimags of Mongolia and 142samples of Mongolian beef and beef imported to Russia from China, respectively were underwent inlaboratory analysis. Wheat was hold at room temperature to reach the regular weight, and muscletissue of meat was dried in a lofildryer. Dried wheat and meat were then powdered into homogenousconsistency and were kept in air proof polyethylene container at room temperature until being analyzed.Selenium content was determined by fluorometric method [2].ResultsOut of wheat sorts grown in Mongolia, selenium was detected in extremely low level in wheat of Khalkhingol sort of Dornod aimag (7±1 mkg/kg) and Selenge sort of Selenge aimag (8±1 mkg/kg), and in wheatsold in retail outlets of Baruunturuun soum of Uvs aimag (7±1 mkg/kg) and Khongor soum of Darkhan-Uul aimag (8±1 mkg/kg). However, selenium content was relatively higher in wheat samples of Darkhan34 sort of Baruunturuun soum of Uvs aimag (31±5 mkg/kg) and of Altaiskaya sort of Jargalant (29±3mkg/kg) and Bornuur (32±1 mkg/kg) soums of Tuv aimag, and in sample of retail wheat of Sagil soum(29±1 mkg/kg) of Uvs aimag.When determined the selenium content in Mongolian livestock meat, in average, the selenium contentwere 109-296 mg/kg in beef, 94-200 mg/kg in lamb, 120-225 mg/kg in horse meat and 124-197 mg/kg ingoat, and the differences were not statistically significant (p>0.5). The highest selenium content of 400mg/kg was detected in horse meat of Govi-Altai aimag.Conclusion: The selenium content in wheat and livestock meat which are the mean stable food forMongolians is considerably low.