Background: More than 60 zoonotic diseases can be transmitted from dogs (Canis lupus familiar’s) to humans, one of which is cystic echinococcosis (CE). Approximately 270 million people in Central Asia live in areas at risk for CE, and Mongolia is included in this region. The transmission of zoonotic infection is facilitated by the movement of humans, livestock, and dogs, as well as trade and cross-border interactions between countries. Aim: To determine the helminth fauna in the dog populations of selected soums of Bayan-Ulgii Province, identify zoonotic pathogens, and investigate Taeniidae infection. Materials and Methods: Seven soums of Bayan-Ulgii province bordering the Russian Federation and the People’s Republic of China were selected using a targeted sampling approach. Domestic dogs belonging to 300 individuals who underwent abdominal ultrasound screening for cystic echinococcosis were included after obtaining consent for deworming. Anthelmintic treatment (5 mg/kg) was administered, and fecal samples from 95 dogs were collected post-treatment. Helminth eggs were identified to determine the helminth fauna. DNA was extracted from samples positive for Taeniidae eggs using a DNA extraction kit (Qiagen, Stool DNA kit, Germany). The mitochondrial cox1 gene was amplified by PCR using F/COI and R/COI primers to determine infection status. Results: The helminth fauna of the dog population in Bayan-Ulgii province consisted of members of the Taeniidae family and the genus Ascaris, as well as Toxocara canis, Trichuris vulpis, Macracanthorhynchus catulinus, Oncicola canis, Strongyloides canis, and Alaria canis. Prevalence rates were as follows Taeniidae 10.5%, T. canis 4.2%, S. canis 3.2%, A. canis 2.1%, Ascaris 2.1%, T. vulpis 2.1%, O.canis 3.2%, M. catulinus 5.2%. Among these, T. canis, T. vulpis, A. canis, and members of the Taeniidae family are zoonotic parasites transmissible from dogs to humans. DNA was extracted from 10 samples positive for Taeniidae eggs. Amplification of the cox1 gene using COI primers revealed an 880 bp band in 9 samples (90%), confirming infection. Conclusions 1. The helminth fauna of dogs in selected soums of Bayan-Ulgii Province consisted of helminths belonging to 1 family, 1 genus, and 6 species. 2. Taeniidae infection was detected in 9.0% of dogs in the selected soums of Bayan-Ulgii Province.

Background: The family Taeniidae (Ludwig, 1886) belongs to the class Cestoda, phylum Platyhelminthes, and order Cyclophyllidea. Zoonotic parasites within this family, particularly Taenia and Echinococcus species, impose a significant socio-economic burden in developing countries. Aim: To determine the prevalence of Taeniidae infection in the domestic dog population of selected soums in Sukhbaatar Province and to identify associated risk factors. Materials and Methods: A total of 135 domestic dogs from seven soums bordering China in Sukhbaatar Province were dewormed, and post-treatment fecal samples were collected for the detection of Taeniidae eggs. DNA was extracted from egg-positive samples using the QIAamp Fast DNA Stool Mini Kit (QIAGEN, Germany). The cox1 gene was amplified using F/COI and R/COI primers through polymerase chain reaction (PCR) to confirm infection. Associations between Taeniidae infection and potential risk factors were analyzed using univariate and multivariate logistic regression analyses. Results: Taeniidae eggs were detected in 35 of 135 fecal samples (25.9%). The mean number of eggs per gram of feces varied among samples. PCR amplification confirmed Taeniidae infection in 30 of the 35 egg-positive samples (85.7%), producing an 880-base pair fragment. The analysis revealed that several owner-related and management-related factors were significantly associated with an increased risk of Taeniidae infection in domestic dogs, including type of residence (OR=12.18; 95% CI: 1.51-98.89; p<0.019), allowing dogs to roam freely (OR=8.08; 95% CI: 2.19–29.73; p<0.002), and feeding dogs raw livestock viscera (OR=265.12; 95% CI: 16.2-4561.7; p<0.0001). Conclusion A 22.2% prevalence of Taeniidae infection was identified among domestic dogs in selected soums of Sukhbaatar Province. Household living conditions, allowing dogs to roam freely without restraint, and feeding dogs raw livestock organs and offal were identified as significant risk factors associated with Taeniidae infection.

Introduction: The treatment of antibiotic-resistant bacterial infections has become a pressing problem for humanity worldwide, and antibiotic-resistant bacterial infections are likely to be the leading cause of death by 2050.Due to the mutation of infectious disease-causing bacteria and the emergence of bacterial resistance due to the improper use of antibiotics, the time and cost of infectious disease treatment increases, and in some cases, it leads to an increase in mortality, so it is the focus of the health sector in every country, regardless of the income level of the population. In addition, bacterial resistance has a negative impact on public health, food safety, the environment, and the economy.
As of 2015, Mongolia ranks among the countries with the highest consumption of antibiotics in the world, with 64.41 units of antibiotics prescribed per 1,000 people per day. Bacteria resistant to broad spectrum antibiotics have increased dramatically, and among Gram-positive bacteria, drug-resistant Staphylococcus aureus (MRSA) has become one of the most common and dangerous cause Purpose: Determine the external structure of liposome-encapsulated antibiotics and evaluate their antibacterial activity. Materials and Methods: We conducted this study using an experimental research design. Phospholipids were isolated by intermittent evaporation, antibiotic encapsulation by freeze-thaw method, and antibiotic sensitivity was determined using standard strains by disc diffusion andmicro dilution method. Research ethics: Permission to submit the survey was granted by the Ethics Review Committee of the MNUMS. The survey was granted in accordance with the rules and regulations. Results: In liposome-encapsulated antibiotic sensitivity assays, azithromycin and clarithromycin did not form sacred circles, whereas doxycycline hyclate was sensitive by forming a 16 mm circle. Doxycycline hyclate encapsulated in liposomes formed a 16 mm circle with sensitive results, whereas blank liposomes were inactive. When the rabbits were infected with a standard strain of methicillin-resistant Staphylococcus aureus, the infected area was purulent 24 hours later. A cream containing antibiotics was started at this time. A deep wound was recovered after 12 days after the pus was removed. Nevertheless, after 24 days, the wound on the rabbit’s infected part healed and the hair on the scraped part grew back. Conclusion According to the dilution method, liposome-encapsulated doxycycline hyclate inhibited bacterial growth at 2-fold lower doses than pure doxycycline hyclate. In experimental animal models, liposome-based antibiotic ointment has shown antibacterial activity.

Introduction: Among the endocrine, nutritional, and metabolic disease and thyroid disorders occupy a significant place. According to the World Health Organization, 8-18% of the world’s population suffer from thyroid disorders. In our country, no research on the prevalence of the disorders has been conducted before, and this research methodology was discussed by the Scientific committee of the National Center for Public Health and was approved by resolution No.156 of the Ethics Committee of the Ministry of Health on 2020. Materials and Methods: In order to determine the prevalence of thyroid disease in the country, we collected the actual number of thyroid disorders registered in 9 districts of the capital city and 330 soums of 21 aimags for a total of 10 years from 2011 to 2020. The prevalence of thyroid disorders was mapped using Arc view and GIS software. Results Endocrine, nutritional and metabolic disease account for 2.3% of all outpatient cases. Endocrine, nutritional, and metabolic disease accounted for an average of 168.3 per 10000 population over the past 10 years, and thyroid disorders accounted for 45 or 26.7% of endocrine, nutritional, and metabolic diseases. Thyroid disorders are highest in people aged 40-49 years.
Thyroid toxicity is the most common type of thyroid disease in Mongolia, accounting for 56.2%, with an average of 17.2 per 10000 population in 2011-2020. However, iodine deficiency-related thyroid disease accounts for 5.5% of all thyroid disorders, with an average of 2.5 per 10000 population in 2011-2020. In 2011, it decreased by 2.2 per 10000 population, and by 2020, it decreased by 0.2 per thousand to 2.0, but in the last 5 years, it has increased by an average of 2.4 per 10,000 population, and in the last 5 years it has increased by 0.2 per thousand, or 2.6 per 10,000 population. Morbidity is high in the Khangai and Central regions.

Background: Lead is known for their neurotoxicity and compared to adults, children are more vulnerable to lead exposure. Varieties of diseases are developed by lead induced damage in children, including decreased intelligent quotient and behavioral changes, such as anxiety. In normal condition lead does not exist in children’s blood and this toxic heavy metal enters into human body through respiratory way and accumulates in blood and bone to harm neurodegenerative and urinary systems. Therefore, the present study aimed to investigate whether the emitted lead from recycling factory for lead acid batteries, which is located in 9 km distance from Khonkhor town and 39 km faraway from Ulaanbaatar city with north-east direction, is affecting the intelligence of the local children. Methods: There are 13 children involved in this study and the participants are divided into two groups, including subjects, who live in areas outside (n=10) and within (n=3) the 1000 m region of the factory zone. The blood sampling was collected according to WHO guidelines and lead level in blood was determined by Leadcare instruments at Environmental health and toxicological laboratory of National Center for Public Health. The intelligence analysis was conducted by Raven’s progressive matrices test. And the statistical analysis was performed by SPSS 21 software to assess correlation of blood lead levels and the intelligence among participated children. Results: It is resulted that average lead level for children’s blood samples is 3.1±1.5 ug/dL and which is found beyond the acceptable range in WHO guidelines. The children’s intelligence was assessed by Raven’s colored Progressive Matrices analysis, which is practically accepted in China, which estimated that average intelligence score of participants were 48.3±13.2. According to correlation analysis of age, sex, intelligence and blood lead level, there was a weak positive correlation was found between children’s age and lead level in blood. In contrast, a weak reverse correlation was observed in regarding with sex and blood lead level and intelligence score was weakly reverse correlated with the lead level in children’s blood samples. Conclusions The determined average lead level was 3.1±1.5 ug/dL for blood samples collected from 13 children who involved in this study and the value is found under the WHO guidance value. Furthermore, their average intelligence score was estimated as 48.3±13.2. The comparative analysis shown that intelligence score of 3 children, who lives within 1000 m region of the recycling factory was lower than those who lives in outside region of the factory and have same age.

Various studies conducted worldwide emphasized the importance of identifying gastric cancer risk factors for better prevention and further incidence reduction. A total of 52 identified risk factors for gastric cancer were classified into nine categories in which diet, lifestyle, and infections are leading causes. Gastric cancer morbidity and mortality has an increasing trend annually in our country. In Mongolia, only 1% is diagnosed in the carcinoma stage, 3% in the first stage, 11% in the second stage, 43% in the third stage, 42% in the fourth stage.
The “Gastric cancer risk factors study, 2018” by L.Tulgaa, and D.Ganchimeg confirmed smoking on an empty stomach as a risk factor. B.Gantuya et al`s (2018) study on gastric cancer and helicobacter infection, as well as S.Tsegmed et al`s (2012) gastric cancer prevalence, its risk factors study, had similar results.
B.Gantuya et al (2018) identified the excessive consumption of salt among the gastric cancer diagnosed population in Mongolia. Also, L.Tulgaa and D.Ganchimeg et al`s “Gastric cancer risk factors study, 2018” results reported the daily consumption of salt in tea is a risk for gastric cancer.
L.Tulgaa et al`s (2018) study participants had irregular mealtime such as dinners are at a very late hour, the meals aren`t chewed well, leftover meals, and seasoning consumption. These characteristics were significantly different in two groups with a statistically important result.
Furthermore, the study results suggested a need to provide practical advice on healthy eating to the population as 50% of the participants consumed more than 5 high-risk food products for esophageal and gastric cancer along with combined risk factors.

The risk of reinfection of the across mutation SARS-CoV-2 set the task of medicine to look for new ways to solve. One of these areas is the strengthening of innate T-lymphocyte immunity. Research on the use of an interferon inducer by stimulating innate T-lymphocyte immunity in order to innate prevent КОВИД-19 and its mutant forms and during the rehabilitation period after an illness, they give good scientific results and one of the future promising directions of prevention and treatment of КОВИД-19. Researchers have warned that the side effects of SARS-CoV-2 drugs include respiratory failure, decreased blood albumin levels, decreased red blood cells and platelets, anemia and coagulation disorders, jaundice, and liver damage. Adverse drug reactions include drug intoxication and adverse reactions, as well as immune reactions. For these reasons, the need to seek new methods of treatment and prevention and drugs has become one of the most pressing issues in modern medicine.

COVID-19 global pandemic is spreading rapidly between close contacts through respiratory droplets. The most effective measures to combat and reduce infection outbreaks include social distancing, movement restrictions, and health sector capacity building, as well as public health. Scientists emphasize the importance of containing the number of positive cases without exceeding current doctors and hospital resources. They concluded that quarantine, particularly complete lockdown is effective in controlling the risk.
Furthermore, the mistakes reported during lockdown enforcement are the only measures to be taken when the infection rate peaks. In the highest infection rate, the intensive care unit needs to increase by 10 percent in only 24 hours if there is no lockdown. In China, complete and partial quarantines in COVID-19 outbreak areas were effective in containing the infection transmission. Mongolia declared a state of emergency and enforced quarantine on November 10, 2020, since the first positive case was reported. Without the quarantine, the number of positive cases is estimated to be 3.2 times higher.

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.

Eye injuries and traumatic cataract in children Background: Ocular trauma in children accounts for 8% to 14% of the total injuries. Childhood eye injury is different from adult ocular trauma in terms of the objects involved in causing injury, evaluation, and management protocols. This study aimed at investigating the current causes, types and outcomes of pediatric ocular and traumatic cataract. Materials and methods: A retrospective observational study of all children admitted to hospital with ocular trauma and traumatic cataract in NCMCH over a 2 years period. Results: There were 126 cases representing, 68.3% were boys and 31.7% girls. 81 8 % were boys and 18-2 % girls. The risk of eye injury in girls was low and stable at all ages, except toddler age, but in boys the risk grew markedly at the age of 4-6 years. The commonest cause of injury was a sharp objects. Other important causes were wooden sticks, pen, pencil and fell from high. Overall, open-globe injuries had a higher frequency (42%) than closed-globe injuries (26.9%). The home was the commonest environment for an eye injury (47.6%). Regarding persons causing the injury, by themselves (61%) was the commonest, followed by child’s friends (24.6%). Total 15.6% of patients retained visual acuity 20/40 or better, while 44.4% of patients resulted visual acuity less than 20/400. In case of traumatic cataract, total 33.3% of patients retained visual acuity 20/40 or better, 14.8% of patients resulted visual acuity less than 20/400 Conclusion: This study describes the clinical characteristics of patients hospitalized for ocular trauma at NCMCH. Health education and awareness are essential tools that can prevent avoidable blindness due to ocular trauma in the pediatric population.