Background: Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases and remains one of the leading causes of cancer-related mortality worldwide. Advances in molecular oncology have shown that mutations in the epidermal growth factor receptor (EGFR) gene play a crucial role in diagnosis and in guiding targeted therapy with tyrosine kinase inhibitors (TKIs). However, the detection of EGFR mutations is influenced by specimen type and quality, and differences may exist between bronchoscopic and surgical samples. In Mongolia, studies addressing this issue remain limited. Aim: To evaluate the feasibility of detecting EGFR gene mutations in bronchoscopic and surgically obtained tissue samples from patients with non-small cell lung cancer (NSCLC). Materials and Methods: This prospective comparative study included 35 formalin-fixed, paraffin-embedded (FFPE) tissue samples, of which 19 were bronchoscopic and 16 were surgical specimens. Tumor cell content was assessed histologically, and genomic DNA was extracted from each sample. EGFR mutation analysis was performed using the cobas® EGFR Mutation Test v2 with real-time PCR. Statistical analysis was conducted using SPSS version 26.0, and differences between groups were evaluated using Fisher’s exact test. Results: The mean age of the participants was 64.5±10.5 years; 74% were male and 26% were female. Significant differences in tumor cell content and DNA yield were observed between specimen types. Bronchoscopic samples showed a mean tumor cell content of 34%, with sufficient DNA yield in 73.6% of cases, whereas surgical specimens demonstrated a mean tumor cell content of 93%, with adequate DNA yield in all cases. EGFR mutations were detected in 31.3% of surgical specimens (including exon 19 deletion, L858R, and T790M mutations). In bronchoscopic samples, insufficient DNA yield in some cases precluded PCR analysis, thereby limiting mutation detection. A statistically significant difference in EGFR mutation detection rates was observed between the two groups (p=0.045). Conclusions 1. Bronchoscopic samples demonstrated lower tumor cell content and DNA yield, which may limit their suitability for molecular analysis in some cases. 2. Compared to bronchoscopic samples, surgically obtained specimens provided higher-quality tissue and demonstrated a greater feasibility for EGFR mutation detection.

Background: Children with developmental disabilities benefit from support in motor skills, sensory processing, cognitive development, and social skills. Mongolia has trained occupational therapists for a decade, with 37% specializing in pediatrics, but long-term therapy facilities remain limited. Aim: This study provides a case report on a child with developmental disabilities who received occupational therapy to evaluate improvements in sensory processing, social communication, and daily living skills. Materials and Methods: The study participants were purposively selected from children undergoing occupational therapy at the “Enerel” Child Development Center. Participant A is a 16-year-old male with hearing and speech impairments, as well as an intellectual disability. The initial assessment showed poor sensory processing and behavioral problems and communication difficulties. A tailored program incorporating sensory-based therapies, communication cards, and sign language was developed with caregiver collaboration. Occupational therapy was conducted five times weekly for 11 weeks. Pre and post test assessments included goal attainment scaling (GAS) and Sensory profile 2 (Child). Results: The participant showed improved communication using cards and sign language, better emotional regulation, enhanced sensory processing, and reduced hyperactivity to external stimuli. Goal Achievement (GAS) +2, meaning the goal was achieved better than expected and positive changes were found on the Sensory profile 2, with large effect sizes. Conclusion The study found that sensory- based occupational therapy and sign language training improved occupational performance and goal achievement in children with sensory, behavioral, and communication difficulties.

Introduction: During this pandemic, overcrowding in classroom caused by a lack of educational facilities and poor indoor air quality are the main causes of respiratory diseases among children and adolescents. Therefore, it is essential to measure and assess the indoor air quality where children spend extended periods of time such as school. Materials and methods: This study covered four schools with old buildings and four schools with new buildings in Bayanzurkh, Sukhbaatar, Khan-Uul, Chingeltei district of Ulaanbaatar. We collected PM10 and PM2.5, carbon dioxide, air temperature, humidity, and microbiological count from chosen classrooms and compared to the MNS4585:2016 standard. SPSS-24 was used to do statistical analysis on the information gathered during the evaluation. Results and Discussion: The 24-hour average PM2.5 concentration was 64.3 (95% CI: 64.1-64.5) mcg/m3, which was 4.3 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016 standard. The 24-hour average PM10 concentration was 85.3 (95 % CI: 85.1-85.6) mcg/m3, which is 1.9 times higher than WHO guideline value. In older school buildings, the 24-hour average PM2.5 concentration was 5.6 times higher than the WHO guideline value and 1.7 times higher than the MNS4585:2016; the average PM10 concentration was 2.8 times higher than the WHO guideline value and 1.3 times higher than the MNS4585:2016. The air temperature and carbon dioxide concentration in classroom was met the MNS4585: 2016. The average relative humidity of all schools is 24.2±6.5%, which is 14-16% lower than the MNS4585: 2016. Conclusion The indoor air quality of the school in new and old buildings was similar poor, therefore a variety of steps are needed to improve it.

Background: Acute appendicitis is an inflammatory disease and acommon cause of acute abdominal pain. The application of the sophisticated automated hematology analyzer more precisely define the morphology changes blood cells. According to this diagnose and treatment control issues are solved by easy and not expensive way. Recent studies haveshown that there is a negative correlation between platelet count (PC) and MPV and that theratio of these two values may be more meaningful. The aim of our study was to investigate thediagnostic value of MPV and the MPV/PC ratio in acute appendicitis. Methods: The patients were divided into two groups based on their histopathological findings: the uncomplicated and complicated appendicitis groups. Leukocyte count, PC, MPV and the MPV/PC ratio were compared all groups. Results: Total of 186 patients, including 119 men, were included in the study. The average age of all patients was 10.21±1.22 years. There was statistically significant difference of some parameters in peripheral blood between the uncomplicated and complicated appendicitis groups in terms of all index. (p<0.001). Leukocyte count had a strong discriminatory property based on the area under curve (AUC) 0.714, (p<0.001). MPV, PC and the MPV/PC ratio had weak discriminatory power with AUC values <0.663. Using receiver operating characteristic (ROC) analysis, the sensitivity and specificity of MPV were 81.56and 45.7%, respectively, and 63.78% and 71.06%, respectively, for the MPV/PC ratio. Conclusions In our study, MPV and the MPV/PC ratio were useful in the diagnosis of acute appendicitis.

Background: In the network of health sector reform, improving the quality and safety of service, organizational development, and ethics and responsibility of doctors and health professionals is a priority issue. To bring this, the patient satisfaction is an important matter. Materials and methods: This study was carried out using a cross-sectional study design with quantitative and qualitative method. To collect data and materials of the study, we used questionnaires from Appendix No.2 of Order 13 of the Minister of Health dated 13 January, 2014. Results: 84 (61.8%) of inpatients evaluated hospital care as a good, while 117 of 197 outpatients (59.4%) evaluated hospital care as an average. The general satisfaction of patients is good for inpatients and average for outpatients. Discussion The patient satisfaction was different depending on the department, gender, age and age group for inpatients, while satisfaction was not dependent on age group for outpatients.

Background: In the network of health sector reform, improving the quality and safety of service, organizational development, and ethics and responsibility of doctors and health professionals is a priority issue. Therefore, it is important to study the satisfaction and needs of healthcare workers, who have essential role in the quality and accessibility of health care service, as well as in social and economic development. Materials and methods: This study was carried out using a cross-sectional study design with quantitative method. The questionnaires were conducted from 63 people who were working in the general hospital of Selenge province. To collect data and materials of the study, we used questionnaires from Appendix No.1 of Order 13 of the Minister of Health dated 13 January, 2014. Results: The Satisfaction score of doctors and healthcare workers which was evaluated by themselves was generally 1.74 ± 0.47 or average, meanwhile 1.62 ± 0.41 or good for each group. Conclusion The employee satisfaction with the General Hospital of Selenge aimag is good. The satisfaction of doctors and healthcare workers is not dependent on the age group, gender, position, and seniority.

IntroductionPolycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-age women,affecting an estimated 5-8% of all women in this age group. Clinically, hyperandrogenism, chronicanovulation, central obesity and polycystic ovary can all occur in women with PCOS and may causeof infertility. Dehydroepiandrosterone sulfate is an androgenic hormone which produced from adrenalcortex and recently, there is no any data determined DHEA-S in patients with PCOS.GoalOur study was designed to determine serum DHEA-S and other hormones in women with PCOS.Materials and MethodWe have used a cross-sectional study design and the study included reproductive-age 18 women withPCOS. ELISA test to determine serum DHEA-S and other sexual hormones was analyzed for all of thesewomen.ResultWhen we analyzed ELISA test to determine serum DHEA-S and other sexual hormones, DHEA-S level8.0±2.1 μg/ml, LH level 9,45±4,3 mlU/ml, FSH level 5,04±1,1 mlU/ml, prolactin level 19,78±12,2 ng/ml, E2 hormone level 16,8±8,9pg/ml, testosterone level 0,25±0,1 ng/ml were in women with PCOS,respectively. And LH/FSH ratio was 2:1 in these women. (p=0.001).ConclusionBy the result, serum DHEA-S, LH,

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-age women, affecting an estimated 5-8% of all women in this age group. Clinically, hyperandrogenism, chronic amenorrhea, central obesity and polycystic ovary can all occur in women with PCOS and may cause of infertility. Dehydroepiandrosterone sulfate is an androgenic hormone produced inadrenal cortex and recently, there is no any data determined DHEA-S in patients with PCOS.Our study was designed to evaluate obesity, central obesity, hirsute grade and infertility and to determine serum DHEA-S hormone in women with PCOS and healthy non-PCOS women.We have used a cross-sectional study design and the study included reproductive-age 36 women, of whom 18 were diagnosed with PCOS and 18 were non-PCOS. Anthropometric components were measured and ELISA test to determine serum DHEA-S hormone was analyzed for all of these women. When we analyzed ELISA test to determine serum DHEA-S hormone, DHEA-S level was2.9±2.0 µg/ ml in non-PCOS reproductive-age women and 8.0±2.1 µg/ml in women with PCOS, respectively (р=0.01). Among the women diagnosed with PCOS had higher incidence of central obesity and grade II hirsute and infertility than healthy women (p=0.001). By the result, higher level of serum DHEA-S in women diagnosed with PCOS may cause of sign of hyperandrogenism such as central obesity, infertility and hirsute.

Neonatal mortality is declining in our FIRST MATERNAL HOSPITAL last few years but the number of preterm babies are increasing. Globally, the main causes of neonatal deaths are preterm birth complications (35 per cent), intrapartum-related complications (complications during labor and delivery) (24 per cent), and sepsis (15 per cent). Together, these three causes account for almost three quarters of all neonatal deaths.We have analyzed 51 medical records who have died in neonatal intensive care unit of Urgoo maternal hospital. 23 questionnaries were analyzed.Premature infant deaths basis of the mother’s birth disorders and mother abnormality. Furthermore, abruption placenta 25.1%, caesarian section 57.1%, hypertonus–21.4%.Prevention of fetal lung under development treatment did not affect 67.8% mortality. Chronic hypoxia is 46.4%, not a day mortality 25.4%, treating was 1–3 days mortality rate is 57.1% is the ability to live shows children die. Compared treated for complications premature infant mortality is 14.2%, causes premature infant mortality is ischemia of brain.Based on the study of maternal hospital mortality in the treatment of premature infants most important thing is CPAP machine it is premature to reduce infant mortality 30.7per cent. Is necessary to use with respiratory distress syndrome infant most important thing is surfactant treatment.

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).