Introduction: Hearing loss is an important public health issue that negatively affects children’s speech, cognitive development, academic performance, and social interaction. Even mild hearing impairment may lead to adverse developmental outcomes. However, data on hearing loss among primary school children in Mongolia remain limited. Goals: To determine the prevalence, type, and severity of hearing loss among primary school students in Ulaanbaatar and to assess associated socio-demographic factors. Material and Method: A school-based cross-sectional study was conducted among 1,254 primary school students. Hearing screening was performed using pure-tone audiometry following a standardized protocol. Students who failed the screening were referred for confirmatory diagnostic audiometry. Hearing loss was classified as mild (21–35 dB), moderate (36–50 dB), and severe (≥50 dB). Socio-demographic data were collected using a structured questionnaire. Statistical analysis data were analyzed using RStudio software. Descriptive statistics were used to summarize participant characteristics. Associations between hearing loss and independent variables were examined using chi-square tests and logistic regression analysis. Variables with p<0.20 in univariate analysis were included in the multivariable logistic regression model. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported, and p<0.05 was considered statistically significant. Ethical considerations: The study protocol was approved by the Institutional Ethics Committee (Approval No. 2024/3 06). Written informed consent was obtained from parents or legal guardians, and assent was obtained from participating students prior to data collection. Results: Of the 1,254 students, 116 (9.2%) required further evaluation, and hearing loss was confirmed in 23 students (1.8%). Most cases were mild in severity. Paternal education level was significantly associated with hearing loss (p=0.028), whereas no significant associations were observed for sex or household income. Conclusion The prevalence of hearing loss among primary school students in Ulaanbaatar was 1.8%, with most cases being mild and unilateral. These findings highlight the importance of implementing regular school-based hearing screening programs and improving parental awareness of children’s hearing health.

Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Introduction: According to the WHO, being exposed to loud noise for a long time can be very harmful to health. It can lead to heart and blood vessel problems, mental health issues, trouble sleeping, and hearing loss. Noise pollution has a negative effect on the brain and nervous system, and it can cause many problems. High-frequency noise, in particular, can disturb the central nervous system. This can lead to problems like poor concentration, more anxiety, and feeling mentally tired. Many studies around the world have shown that noise levels of ≥85 dB at work increase the risk of noise-induced hearing loss (NIHL) and tinnitus.In Ulaanbaatar, environmental noise pollution continues to grow due to population growth, construction, and urban planning. Therefore, it is important to find out whether environmental noise pollution is linked to mental and behavioral disorders, insomnia, nervous fatigue, high blood pressure, and hearing loss among the population. Goal: The aim of this study is to examine the prevalence of primary hypertension (I10), nervous fatigue (F48.0), sleep disorders (F51.0), and tinnitus (H83.3) caused by environmental noise among the population of Ulaanbaatar. Materials and Methods: A descriptive research design was applied to examine statistical data from the Center for Health Development regarding diseases related to noise pollution. Based on the 10th revision of the International Classification of Diseases (ICD-10), the study focused on conditions such as neurasthenia (F48.0), non-organic sleep disorders (F51), primary hypertension (I10), and hearing disorders (H83.3). The analysis included data recorded between 2014 and 2023 among the population of Ulaanbaatar city. Epidemiological analysis was performed using SPSS-24 software, and the results were calculated per 10,000 population. Ethical Considerations: This study did not receive any external funding or financial support from public or private organizations. It utilizes secondary data from the Health Development Center, which does not contain any personal information. Results: In 2014, the average age of individuals diagnosed with neurasthenia (F48.0) was 40.1±12.6 years; for non-organic sleep disorders (F51.0), it was 48.1±14.5 years; for noise-induced hearing disorders (H83.3), 47.2±12.7 years; and for primary hypertension (I10), the average age was 59.0±11.4 years. By 2023, the average age for primary hypertension had slightly decreased to 58.0±12.9 years. Since 2014, the number of cases of nervous fatigue, non organic sleep disorders, and hearing problems caused by noise has risen in Ulaanbaatar. In 2023, the average age of people with primary hypertension (I10) dropped to 58.0±12.9 years. Noise-related illnesses are common among people aged 40 to 60 in Ulaanbaatar, and this is lowering their quality of life. Conclusion Noise-related illnesses are being recorded among the 40–60 age group in Ulaanbaatar, which is negatively affecting their quality of life. It is urgently necessary to introduce measures for adequate protection of the population from the negative health effects of environmental noise.

Perinatal mortality, which includes stillbirths after 22 weeks of gestation and neonatal deaths within seven days after birth, varies widely across countries. Developed nations report rates below 10 per 1,000 births, while developing countries often exceed 50. In 2022, Mongolia reported a rate of 13.2, higher than in developed nations but showing improvement. Urbanization influences perinatal mortality through factors such as air pollution, limited healthcare access, and socioeconomic inequality. In Ulaanbaatar, severe winter air pollution increases the risks of preterm birth, low birth weight, and stillbirth. In contrast, rural areas face barriers including poor access to maternal care and transportation delays. Strengthening prenatal care, neonatal services, and ensuring the safe use of medications during pregnancy are critical to reducing perinatal deaths. This literature review, based on 50 domestic and international literature sources, provides an in-depth examination of how urbanization affects perinatal mortality.

Background: In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis. Aim: To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis. Materials and Methods: A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively. Results: At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001). Conclusion The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment of plaque-induced gingivitis.

Background: Meniere's disease is a condition caused by disturbances in the auditory and vestibular systems. It is characterized by symptoms such as dizziness, nausea, vomiting, and tinnitus. In the United States, the prevalence of Meniere's disease has been found to be 84 cases per 100,000 women and 56 cases per 100,000 men. Regionally, it is more common in less populated areas, and research has confirmed that the prevalence increases with higher household income. Aim: To evaluate the effectiveness of traditional medicine treatments and therapies for Meniere's disease. Results: The patient is a 43-year-old male, with symptoms of dizziness, vomiting, and tinnitus. Since 2023, he has sought care at the Central Hospital of Mongolian Medicine, where he received traditional medicine treatments including herbal therapy and other traditional therapies on three occasions. As a result, the frequency of dizziness has decreased and other clinical symptoms have improved. Conclusion Traditional medicine treatments have been shown to be effective in managing Meniere's disease by extending the interval between relapses, improving quality of life, and significantly reducing clinical symptoms.

Background: Rhododendron adamsii (Sagaan Dalya) is a medical plant widely distributed in the Altai region, Mongolia, and Russia. It is traditionally used for its calming, restorative, and immune-boosting properties. Inflammation is a complex immune response against pathogens such as bacteria, viruses, and fungi, involving macrophages, fibroblasts, mast cells, and neutrophils. These cells release inflammatory mediators such as nitric oxide (NO), TNF-α, and IL-1β. In collaboration with the Russian Foundation for Basic Research, a project was initiated to investigate the bioactive fractions of Rh. rosea (L.) and Rh. adamsii and their effects on the production of TLR4 signaling end products and associated protein activation. Previous studies within this project have shown that certain bioactive fractions exhibit anti-inflammatory activity. Specifically, fraction 7.11 suppressed NO production and inflammatory signaling molecules in LPS-stimulated RAW 264.7 macrophages, while fractions 7.46 and 7.52 influenced the phosphorylation of proteins such as ERK1/2, JNK, and IRF3. These findings suggest the need for further investigation into the effects of Rh. adamsii bioactive fractions on inflammatory signaling pathways. Aim: This study aims to evaluate the effects of bioactive fractions derived from Rhododendron adamsii on the production of TLR4 signaling end products in RAW264.7 macrophage cell cultures. Materials and Methods: The study was conducted using RAW264.7 macrophage cell cultures and bioactive fractions extracted from Rh. adamsii, dividing the experiments into three groups. After stabilization, RAW264.7 cells were stimulated with 100 ng/mL LPS. Based on previous studies, non-toxic concentrations of bioactive fractions (10 µg/mL) were applied. NO production was measured using the Griess assay, while TNF-α and IFN-β cytokine levels were evaluated using ELISA. Each experiment were repeated three times, and data were statistically analyzed using SPSS 25.0, applying One-way ANOVA and Independent Samples T-test. Results: The NO production in the positive control group was significantly higher compared to the negative control. In contrast, the experimental groups showed a statistically significant reduction in NO production, suggesting a potential inhibitory effect on TLR4 signaling in macrophages. However, fraction 7.48 reduced TNF-α levels while increasing IFN-β production, but these changes were not statistically significant. Similarly, fraction 7.55 slightly reduced TNF-α and IFN-β levels, but the effect was also statistically unsignificant. Conclusion The bioactive fractions 7.48 and 7.55 of Rh. Adamsii reduced nitric oxide (NO) production in LPS-stimulated macrophage cell line cultures, suggesting that they may inhibit TLR4 signaling. However, their lack of effect on TNF-α and IFN-β production indicates that they do not influence TLR4 signaling mediated by these cytokines. Instead, they may affect the final product output through other pathways or different stages of signal transduction.

Abstract Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions of people worldwide. Significant advancements in both diagnostic and therapeutic approaches have greatly improved outcomes, particularly for individuals with drug-resistant epilepsy. Modern neurostimulation techniques such as Responsive Neurostimulation (RNS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS) have demonstrated effectiveness in reducing seizure frequency in these patients. Additionally, emerging technologies like gene therapy and optogenetics are being explored to better understand the underlying mechanisms of epilepsy and hold promise as future treatment modalities.Traditional imaging techniques often fail to detect subtle epileptogenic zones. However, the introduction of ultra high-field 7T MRI scanners represents a major breakthrough. These advanced scanners use eight transmitters to generate higher-resolution images, reducing signal dropout and enabling the identification of previously undetected lesions. In one study involving 31 patients, 58% had their treatment plans modified based on 7T MRI findings, highlighting its potential to inform surgical decision-making. In terms of pharmacological treatment, newer medications such as sultiame, cannabidiol (CBD), and non-pharmacological approaches like the ketogenic diet have emerged as additional therapeutic options for drug-resistant epilepsy. These developments contribute to more effective, personalized management strategies for epilepsy. In summary, the landscape of epilepsy diagnosis and treatment is rapidly evolving. Innovations in imaging and therapeutic interventions are offering new hope for patients with drug-resistant epilepsy. Ongoing research and clinical trials remain essential to further refine these approaches and improve patient outcomes.

Background: Perinatal mortality is a key indicator of maternal and newborn health. Ulaanbaatar experiences severe seasonal air pollution, which may be associated with adverse perinatal outcomes. Material and Method: A cross-sectional study was conducted using official perinatal mortality data from Ulaanbaatar for 2023–2024. A total of 53,256 births were recorded. Among these, 489 perinatal deaths were identified, including 257 stillbirths and 232 early neonatal deaths.
Perinatal mortality rates were calculated per 1,000 total births at the district level. Associations with ambient air pollutants (PM₂.₅, SO₂, CO, and NO₂) were assessed using Pearson correlation analysis and multivariable logistic regression. Maternal age, residential area, and pregnancy complications were included as covariates.
The research protocol was approved by the Research Ethics Committee of “Ach” Medical University (Approval No. 2025/04). All data were anonymized prior to analysis. Results: The overall perinatal mortality rate was 9.2 per 1,000 total births. The stillbirth rate was 4.8 per 1,000 total births, while the early neonatal mortality rate was 4.4 per 1,000 live births. District-level variation was observed, with the highest perinatal mortality rates reported in Chingeltei (18.3‰), Sukhbaatar (14.1‰), and Songinokhairkhan (10.2‰) districts. Seasonal variation was evident, with mortality peaking during winter and autumn.
PM₂.₅ concentrations exceeded national air quality standards by 3.4–8.2-fold during winter and showed a significant positive correlation with stillbirth rates (r = 0.68, p < 0.05).
In multivariable logistic regression analysis, maternal age ≥35 years (OR = 1.68, 95% CI: 1.12–2.54) and residence in ger districts (OR = 2.18, 95% CI: 1.54–3.08) were independently associated with higher odds of perinatal mortality Conclusion Perinatal mortality in Ulaanbaatar remains higher than international targets. Environmental and sociodemographic factors were significantly associated with perinatal mortality, suggesting that both environmental exposures and urban health inequalities may contribute to adverse perinatal outcomes. Targeted public health interventions are needed to reduce environmental risks and improve maternal and neonatal health.

Introduction: In 2020, the prevalence of respiratory system diseases in the population of Gobi-Altai province is 1339.5 cases per 10,000 population, which is 4% (52) more than the average of the provinces and 20% (223.8) more than the national average. In 2021, the number of deaths due to respiratory system diseases was 2.9 per 10,000 population, increasing by 1.1 from 2020 (1.8). Pneumonia-related deaths account for 60.7% of all respiratory system-related deaths. As of 2022, there are 7,281 simple stoves, 248 low-pressure and steam boilers, and 18,207 automobiles in the Gobi-Altai province as sources of air pollution. 63.1% of the total coal is consumed by water heating boilers with a capacity of more than 101 kW, 20.5% by households, and 16.4% by small and medium enterprises. Goal: Determining the relationship between the incidence of pneumonia in the population of Gobi-Altai province and the common air pollutants. Material and Method: According to the rotation research model, the common external air pollutants SO₂, NO₂, PM₁₀, climate parameters, temperature, pressure, humidity, and population pneumonia measurements and registration data of Altai Sum, Gobi-Altai Province in 2020-2021 were analyzed using SPSS-24 software. statistical processing was calculated for non-parametric parameters. Result: The annual average value of sulfur dioxide (SO₂ ) measured in 20 minutes in Gobi-Altai province is 25.2 ± 13.7 μg/m³, the annual average value of nitrogen dioxide (NO₂) measured in 20 minutes is 36.329±29 μg/m³, and the annual average concentration of PM₁₀ particles is 35.2 ± 28,264 μg/m³, which is the standard level of MNS4585:2016. But the 20-minute average concentration of SO₂ (r=0.81, p=0.005), the average concentration of NO₂ (r=0.089, p=0.008), and the average concentration of PM₁₀ (r=0.089, p=0.002) is directly related to the incidence of pneumonia. It is also inversely correlated with air temperature (r=-142, p=0,000). Conclusion Common outdoor air pollutants in Yesunbulag sum, Gobi-Altai Province are related to pneumonia in children aged 0-5 years.