The result of using the calretinin and BCL-2 markers for diagnosing hirschsprung disease Background: Hirshsprung disease is a congenital malformation by the absence of parasympathetic intramural ganglion cells of submucosal and myenteric plexuses in the rectum and varying lengths of bowel proximal to the rectum,resulting in a functional obstruction. Hirshsprung disease occurs in approximately 1 per 5000 live births. Rectal biopsy is the gold standard for the diagnosis.Despite the importance of using hematoxilin eosin in the diagnosis of HD, detection of ganglion cells in basic stain section can be a difficult process for the pathologist.The relatively undifferentiated and non neuronal appearance of immature ganglion cells that exist in the sub-mucosa of neonates and infants is frequently cited as a difficulty associated with hematoxilin eosin based diagnosis of HD. According, immunohistochemical and histochemical stain are used to confirm the diagnosis of HD by pathologists.2 years ago we start to use Calretinin and Bcl-2 markers for HD diagnosis at National Center for pathology in Mongolia. We don’t have research which compared hematoxylin eosin and IHC markers. Materials and methods:The study conducted using a cross-sectional model of analytical research. The Department of Pediatric Pathology of the National Center for Pathology conducts studies of rectal biopsies of 54 children who clinically suspected of Hirschsprung's disease between January 2018 and December 2019. The tissue samples stained with hematoxylin-eosin, immunohistochemical Bcl-2, calretinin markers, and the detect of nerve cells compared with the sensitivity and specificity of the test and the compatibility of the diagnosis. Results:In terms of age, 42.6% (n = 23) of infants aged 0–28 days, 38.9% (n = 21) of infants aged 29–365 days, 1.9% (n = 1) of 2 months to 2 years of age, and 7% of aged 3–5 years (n = 13), 6–12 years of age accounted for 3.6% (n = 2). 80.1% of the total surveyed children are infants and lactating children or under 1 year old. In a total of 54 children in the study, absence of ganglion cell was detected in 63% (n = 34) of hematoxylin eosin, 44.4% of calretinin markers (n = 24), and 40.7% of Bcl-2 markers (n = 22). Nerve cells were diagnosed with hematoxylin eosin staining in 37%, calretinin markers in 55.6%, and Bcl-2 markers in 59.0%. Sensitivity was determined as 91.7%, specificity as 60.0%, positive prediction rate as 64.7, negative prediction rate as 90.0, and diagnostic agreement compliance (Kappa = 0.500), (p = 0.001). Conclusions: Hirschsprung's disease diagnosed 44.7%(n-24) in rectal tissue samples. According to the result of the study, calretinin showed the highest reactivity to ganglion cells and proved to be the most specific and sensitive marker for diagnosis of Hirschsprung’s disease.

The Western Pacific Region have the highest neonatal mortality rate of any country in the world. It has 37 countries and areas with approximately 1.8 billion people which comprises one-fourth of the total world population. The First Embrace It is care for all mothers and newborn infants. The components of the First Embrace are immediate and thorough dying, appropriately timed clamping and cutting of the cord, skin to skin contact and initiating exclusive breastfeeding for all newborns. Aim: First embrace and Early Essential Neonatal Care the importance of infant seeks to to learn some of the problems faced by identifying the skills of medical personnel. We were conducted in this study by a cross sectional questionnaire in order to assess the knowledge, attitude and practices of healthcare providers about essential newborn care and administrated a structured questionnaire to evaluate instruments and materials of the maternity wards.Skin to skin contact and a mother first embrace is the beginning of a healthy life is to reduce the newborn mortality. And the first embrace is improves the children’s immunity. We determined urgent problems for EENC including a lack of maternal health education, inadequate salaries for health care providers, a lack of essential medicines and commodities for birth preparation and numbers of health care providers delivering neonatal intensive care are increased due to the stillbirth rate has increased dramatically year by year.The first embrace is important to reduce neonatal mortality rate and 92.0% of all participants have the enough experiences for the first embrace care and 80.3% of all participants for the EENC.

Risk of nephrotith disease increases relating with using high hardened water, not suitable diet, being sensitive for some kind of food products. Then for Mongolia, particularly Bulgan province which is located in basin of the Selenge river is consisted in regions which have high hardened water. Sickness rate of renal diseases especially nephtolith disease is high in population of Selenge soum of Bulgan province. It was main reason of choose this subject and investigate non organic substances in urine of population and determine risks of nephtolith disease for them. To determine оne of the factors affecting the formation of the disease is to study the composition of drinking water and investigate non organic substances in urine. We used cross-sectional methodology for our study. Our study was conducted from June, 2013 to November, 2014. Household water used portable water dissemination and homes with private wells and water samples from the river.Drinking water analyzed of the chemistry parameters (13 substances) in the chemistry and toxicology laboratories in Orkhon aimag. There was 300 urine analyze was done and 62 of them was confirmed nephtolith disease with it. We investigated non-organic substances in their urine. Interviews people in the study, the average age was 43.26±14.7. 64.2% of participants was answered that they use ground water (private groundwater wells), 25.4% use external water (the well water), 8.1% use river water, 2.3 use pure water when asked about their water supply. Composition of samples from drinking water standard was near to the standard assessments by comparing the maximum amount of. We were considered the most important water pH, solids, iron, chlorine analysis compares removable wells and private wells. Hardness for 53.3% of the well of 2.5-3.5 mg/l with hard water, private wells, 60.0% of 4.6-5.5 mg/l solids by of water. Wells chlorides portable 66.7% 14.4-25.3 mg/l, and private wells 13.3% of 4.3-14.3 mg /l. 20.7 percent of survey identified as the kidney and urinary tract diseases. Urat salt (32.1%), compound of urat and sodium (32.1%), oxalate (14.5%), sodium (13.4%), compound of oxalate and sodium (6.4%), phosphate (1.5%) was determined in urine analyze. It was close to the water content of the standard performance. The well water solids of 2.5-3.5 mg/l and private groundwater wells solids of 4.6-5.5 mg/l. And the well chlorides 14.4-25.3 mg/l and private groundwater wells chlorides 4.3-14.3 mg/l.Urat and compound of urat and sodium are dominated in composition of stone during nephrolith disease (p=0.043).