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.

Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

Introduction: With the average longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. A metabolic and hormonal change occurs in male during aging.The level of total, free and bioavailable testosterone decline with aging and it leads to decrease in sexual activities, metabolism and also the life quality.The aim of this initial study was the determination of free testosterone and bioavailable testosterone and it was the novelty of our study. Data obtained from our research can be used as basic information for hormone replacement therapy in late onset hypogonadism.Research goal: To study the free testosterone and bioavailable testosterone level in aging malesMaterials and Methods: This study is a part of study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. The study was approved by IRB of MoH and written consent was obtained from all participants.Fasting blood samples were collected in the morning between 8.00-10.00 AM. We used commercial ELISA kits from Magiwel CoLtd (USA) for determining the total testosterone, sex hormone binding globulin levels. Bromcresol green method was used in determination of serum albumin level. Bioavailable and free testosterone were calculated by Alex Vermeulen, Lieve Verdonk and M. Kaufman’s formula, which was recommended by International Society for the Study of Aging Male.We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination.Result and discussion: The average age was 57.48±10.48 years in our study participants. In group of 40-49 years were 29% (n=33), in 50-59 age group 23% (n=26), in 60-69 age group 27% (n=38) and in age group over 70-s were 15% (n=17).Mean total testosterone was 6.04±1.83 ng/ml, in 40-49 age group it was 6.14±1.65 ng/ml, in 50-59 age group 6.04±2.36 ng/ml, in 60-69 age group 6.05±1.80 ng/ml, and over 70’s it was 5.85±1.43 ng/ml.Mean sex hormone binding globulin was 50.22±29.97 nmol/l, in 40-49 age group 37.60±23.03 nmol/l, in 50-59 age group 47.08±29.61 nmol/l, in 60-69 age group 57.24±33.91 nmol/l, and over 70’s it was 59.22±25.38 nmol/l.Mean albumin was 40.86±6.89 g/l, in 40-49 age group 44.55±5.93 g/l, in 50-59 age group 41.85±6.93 g/l, in 60-69 age group 38.92±6.85 g/l, and over 70’s was 36.55±4.77 g/l.Mean free testosterone was 0.112±0.064 ng/ml, in 40- 49 age group 0.124±0.058 ng/ml, in 50-59 age group0.114±0.077 ng/ml, in 60-69 age group 0.107±0.072 ng/ml, and over 70’s it was 0.097±0.044 ng/ml.Mean bioavailable testosterone was 2.53±1.48 ng/ ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml.Conclusion:1. In our participants aged above 40 years old, the average mean of free testosterone was 0.112±0.066 ng/ml, free testosterone index was 16.95±11.82. Free testosterone had inverse correlation with aging (r=-0.168, p=0.03) and had peer decline among aging groups.2. The average mean of bioavailable testosterone was 2.53±1.48 ng/ml, and had age related inverse correlation (r=-0.169, p=0.037), which decline was deeper in men aged over 70 years.Key words:Aging, total, free, bioavailable testosterone,free testosterone index

Introduction: Erectile dysfunction (ED), also known as impotence, is defined as a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual performance [1]. According to recent study results, ED occurs more than 50% over 60 year old males, emphasizing a need to diagnose and treat it at an earlier stage. ED may be assessed in several ways. The most widely used standardized questionnaire is the International Index of Erectile Function (IIEF) with 15 questions, which also exists in a short form with 5 questions [2]. On the other hand, ED is associated with a decreased level of androgens in aging males; the latter is often referred to as a Late Onset Hypogonadism (LOH) or Testosterone Deficiency Syndrome (TDS). In simple terms, LOH or TDS can be defined as a decreased serum testosterone level in aging males [3, 4]Objective: To detect the testosterone deficiency syndrome in aging males with erectile dysfunction. Materials and Methods. 309 males over 40 years of age who received medical care at the ADAM urological and andrological clinic from 2010 to 2011 were included in this study. An approval of the Ethical Committee of MOH was obtained at the commencement of the study. Each study participant signed a consent form at the beginning of the study. Each participant was assigned to either an ED group or a control group depending on results of the IIEF-5 questionnaire. The ED group was further divided into three groups (moderate, severe and very severe) based on a level of ED. The total testosterone (TT) levels were determined in blood serum, using a competitive ELISA analytical system UBI MAGIWELTM TestosteroneQuantitative test (GLS, USA), with C.V. (%) 6.8 and free testosterone (FT) calculated as described by Vermeulen. Test samples were collected between 8.00-11.00 am. The biochemical diagnosis of TDS was based on the Study Aging Male (ISSAM) guidelines of the International Society, particularly, if TT was _3.46 ng/ml or free testosterone FT was ≤0.072 ng/ml [5].Results: ED of moderate, severe and very severe levels were diagnosed in 199 (64.41%) out of 309 participants. There was an inverse association between an erectile function and age (r=-0.380, p <0.01). The average TT was 5.75±2.316 ng/ml and FT was 0.091±0.0084 ng/ml. Compared to the ED group, the control group had a higher TT level: 5.6440±1.177 ng/ml and 5.812±2.316 ng/ml respectively. In the control group the FT level was 0.061±0.0084 ng/ml whereas it was 0.041±0.0076 ng/ml in the ED group. Conclusion: Our study showed that most of aging males who came to the clinic had a moderate to very severe ED (64.55%). The level of TT (5.644±1.177 ng/ml) and FT (0.041±0.0036 ng/ml) was significantly lower in ED patients (p<0.05). The testosterone deficiency syndrome was detected in 24.27% of the ED group.

Introduction: With the increasing longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. The of this study in aging men. Late onset hypogonadism will need the testosterone replacement therapy and we hope that our study result will help to get basic information of testosterone among over 40 yearsold Mongolian men.Goal: To determine the bioavailable testosterone (BT) of aging males and correlate with aging process.Materials and Methods: This study is a part of ongoing study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination. Bioavailable testosterone was determined by formula suggested by ISSAM.Result: The average bioavailable testosterone level was 2.53±1.48 ng/ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml. If consider the bioavailable testosterone 100%, in 40-49 age than it is decreasing 94.2% in 50-59, 90.9% in 60-69 ages and 73.9% decreased in over 70s. Respectively, it decreases approximately by 0.9% every year after 40’s.Conclusion: The bioavailable testosterone level was 2.53±1.48ng/ml in aging males and has reverse correlation with aging (r=-0.169, p=0.037).

Materials and Methods: We studied 114 healthy males aged above 40 years old, who undergone urologists examination and General practitioner. All men answered the Aging Males’ Symptom Scale questionnaire. This is part of the ongoing study Mongolian males Andrological Status sponsored by Asian Research center, Korean Foundation for Advenced Studies. Formal concent permission was obtained from all participants, which approved by Ethical Committee of MoH. We took 4 ml blood from vien between 8-11am and determined testosterone, SHBG by ELISA and albumin by liquicolor reagent. Bioavailable testosterone was calculated, using previously described mathematical modeling, suggested by ISSAM.Result: The average free testosterone level was 0.112±0.06 ng/ml, in 40-49 age group 0.124±0.05 ng/ml, in 50-59 age group 0.114±0.07 ng/ml, in 60-69 age group 0.107±0.07 ng/ml, and over 70’s it was 0.097±0.04 ng/ml. If consider the free testosterone 100%, in 40-49 age than it is decreasing 91.6% in 50-59, 83.3% in 60-69 ages and 75% decreased in over 70s. Respectively, it decreases approximately by 0.8% every year after 40’s.Conclusion: The free testosterone level was 0.11±0.06 ng/ml in aging males and has reverse correlation with aging (r=-0.168, p= 0.03).