Study about caeserean section In nulliparous women Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Materials and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Background: Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2].
In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3].
Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5].
During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD.
Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province.
Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7]. Purpose : Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections. Material and Method: Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens.
Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites. Result and conclusion Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis.
Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province.
247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%).
By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.

The microbiologist, who aged 44 man has work with glander DNA extraction between January and March at 2022, was developed sumptoms with fever, headache, muscle pain, weakness, cut throat, cough at 4 March, 2022. On March 7, he had tested Covid-19 and the result was negative. He was given 1gr tefazoline by eight-time interval for two days. Despite completing the therapy, episodes of fever and headache increased. A medical evaluation, which included MRI test was no disorder was developed. On March 12, painful with leg and developed muscle pain. He continued to difficulty to walk and cough, fever and weakness. On March 13, he has admitted hospital with diagnoses pneumonia.
He had continued sign with pneumonia in both lung, fever, infiltration with right leg, cough, headache, and glandule node in hospital. By PCR test, glander DNA was detected in sputum in National Center for Zoonotic Diseases laboratory. He recovered 20 days in hospital.
He has 12 days incubation period and infection route was by worked with glander strain and it was pneumonia form with laboratory-acquired human glanders.
Human glander case is rare in Mongolia. Three human glander cases had registered in 1966, 1972, 1977 among prison’s horse herder in Mongolia.

Background: The knowledge about the normal and abnormal vaginal microbiome has changed over the last years. The normal and the abnormal vaginal microbiota are complex ecosystems of more than 200 bacterial species influenced by genes, ethnic background and environmental and behavioral factors. Major changes in the vaginal physiology and microbiota over a woman’s lifetime are largely shaped by transitional periods such as puberty, menopause and pregnancy. Many studies have shown that bacterial vaginitis (BV) has an increased risk of preterm birth, miscarriage, premature rupture of membran, and postpartum uterine inflammation and sepsis. To assess different bacterial and epidemiological factors associations with increased vaginal pH in the women of reproductive age. Methods: In the 1st Health center of Bayanzurkh district hospital, 100 non-pregnant women were randomly selected between 18-45 years of age. Women were submitted to an interview, vaginal examination and vaginal specimen collection for pH measurement and microscopy. Descriptive statistics are reported for the vaginal pH according to a specially designed survey card, the survey respondents assessed the status of the mother’s health. Results: The non pregnant group studied herein were mostly young adults with ages in the age range 25-29 (32.0; 32%, mean±SD: 29.1±5.7) years. The vaginal pH mean in non-pregnant women was 4.5±0.5. Elevated vaginal pH was signicantly associated with bacterial vaginosis (p < 0.001), and bacterial vaginosis flora (p < 0.001). 162 of 200 women (81%) had an increased vaginal pH. 65,8% of participants in research were normal nugent score. Conclusion In non-pregnant women, the vaginal pH mean was 4.5 ± 0.5. Changes in vaginal pH are statistically significant with age, and clinical manifestations. /р<0.05/. The human vaginal ecosystem is a dynamic environment in which microbes can affect host physiology but also where host physiology can affect the composition and function of the vaginal microbiota.

Objective: To retrospectively analyze the drug resistant characteristics and distribution of multi-drug resistant bacteria infection in State Second General Hospital. Methods: Total 772 cases treated in our hospital from January 2017 to September 2019 were selected as subjects. The automatic microorganism analyzer VITEC-2 and manual method were used for bacterial identification; Kirby-Bauer disk diffusion method was used for susceptibility test; WHONET 5.6.2019 software and EXCEL 2013 were used to analyze the distribution and drug sensitivity of isolated bacteria. Results: Among the 772 strains of multi drug resistant bacteria, the proportion of Gram-negative bacteria was 84.9%, and the proportion of Gram-positive bacteria was 15,1%; fluconazole resistant candida accounted for 3.2%. Multi -drug resistant bacteria mostly distributed in sputum, accounting for 23.5%; 50.5% multi-drug resistant strains were from intensive care unit.
Resistant rates of Escherichia Coli ESBL, Klebsiella ESBL and Enterobacter spp to cephalosporins and penicillin were 100%. Resistant rates of staphylococcus aureus to antibacterial agents; cephalosporins and penicillin were 100%. Conclusion Gram-negative bacteria were the main multi-drug resistant bacteria of our study in our hospital, mainly distributing in Intensive care unit patients. They are highly resistant to most antibacterial agents, which provides a theoretical basis for the prevention and control of multi-drug resistant bacteria infection in hospital.

Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare. The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.

Medicinal leech /Hirudo medicinalis/ secretes 150 over bioactive substances from savilary gland, which are hirudin, hialuronidasa, bdellin, eglin, destabilasa, lipase, cholesterol esterase. Medicinal leech’s therapeutic effect is anticoagulant, antiplatelet, anti-ischemic, hypotensive, anti-inflammatory, anti-atherosclerotic and thrombolytic. In Mongolia, medicinal leech therapy’s research is rare.The study was designed as selective sampling and clinical trial study. From June 1st between September 1st in 2016, there were enrolled 30 patients with diagnosis of arterial hypertension stage I at “Piyavka” hospital in Hentii province. Patients were used by method of Medicinal leech therapeutic of the Russian Federation in 2011. Blood samples were used SD LipidoCare analyser, Stago Compact automatic coagulation analyzer. Fibrinogen, Activated partial thromboplastin time, Thrombin time, Prothrombin time, International normalized ratio and Blood lipids level were checked before and after treatment. A total of 30 patients were enrolled in the study. 16 were females, 14 were males and the mean age was 59.13±11.62. Activated partial thromboplastin time was before 37.97 ±5.62 sec and after 45.94±6.05 sec therapy of leeches. Thrombin time was before 17.59 ±1.66 sec and after 19.53±1.38 sec therapy of leeches. As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol was before 220.63±14.51 mg/dl, after 204.63±13.64 mg/ dl therapy of leeches. Triglyceride level was before 253.69±71.99 mg/dl, after 184.12±61.73 mg/ dl therapy of leeches. Mean of Activated partial thromboplastin time, Thrombin time were prolonged with statistically significant after treatment (p=0.0001). As patients who was increased from normal lipid level in blood before leech therapy, Total cholesterol (p=0.031), Triglyceride (p=0.0003) were decreased with statistically significant by therapy of leeches.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.

Bullying or peers violation is one of adolescent`s truly urgent issue but it is not public discussion topic. We conducted a study in 3 different schools which began from 6th of October, 2014 to 13th of October, 2014. There are total 167 subjects aged between 13-18 were from classes of junior and senior- high at: Orchlon school, School of 1 and School of 13. We used 53- item Questionnaire consisted of 4 sections for our study. We concluded 98(58.7%) participants from School of 1, 26(15.6%) participants from School of 13 and 43(25.7%) participants from Orchlon school who were aged between 13-17 (M=14.7±0.1) which comprise of 84 (50.3%)male and 83 (49.7%) female in our study We assessed correlation of depression and bullying by linear regression. The result of it shows 1 more score of depression measuring scale-CES-D can rise score of Aggression scale 1 by 0.33 point and also it can rise score of Aggression scale 2 by 0.84 point. There is a positive correlation between bullying and depression which confirms high risk of bullying is associated with majordepression in significantly. (p value 0.000) The findings of the study reveals that high levels of bullying associated with high levels of depression.

Background Abdominal ultrasonography assesses the size, echotexture, shape, contour and adjacent structures of pancreas. Goal The goal of our study is to determining ultrasonography criteria of acute and chronic pancreatitis and developing algorithm of differential diagnosis. Objectives 1. To determine ultrasonography criteria of acute and chronic pancreatitis 2. To develop algorithms of differential diagnosis of acute and chronic pancreatitis Material and Method During the study period, 81 patients with acute pancreatitis, 66 patients with chronic pancreatitis has examined byultrasonography in Reference centre on Diagnostic Imaging named after R. Purev state laureate, people’s physician,hoporary professor of the State III nd Central Hospital,AchtanClinicalHospi tal,Central Clinic of Ulaanbaatar railway and Hepatological clinic centre of traditional medicine Result 48 (59.3%±5.5) patients with acute pancreatitis had reported pancreatic swelling /Exudative pancreatitis/, 18 (22.2%±466) had acute hemorrhagic pancreatitis, 15 (18.5%±463) had necrotizing pancreatitis. Conclusions 1. Determined ultrasonographic criteria of acute and chronic pancreatitis 2. Acute and chronic pancreatitis has diagnosed by ultrasonographic criteria and developed differential diagnosis algorithm.