Background: Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2].
In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3].
Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5].
During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD.
Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province.
Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7]. Purpose : Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections. Material and Method: Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens.
Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites. Result and conclusion Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis.
Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province.
247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%).
By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.

Objective: To retrospectively analyze the drug resistant characteristics and distribution of multi-drug resistant bacteria infection in State Second General Hospital. Methods: Total 772 cases treated in our hospital from January 2017 to September 2019 were selected as subjects. The automatic microorganism analyzer VITEC-2 and manual method were used for bacterial identification; Kirby-Bauer disk diffusion method was used for susceptibility test; WHONET 5.6.2019 software and EXCEL 2013 were used to analyze the distribution and drug sensitivity of isolated bacteria. Results: Among the 772 strains of multi drug resistant bacteria, the proportion of Gram-negative bacteria was 84.9%, and the proportion of Gram-positive bacteria was 15,1%; fluconazole resistant candida accounted for 3.2%. Multi -drug resistant bacteria mostly distributed in sputum, accounting for 23.5%; 50.5% multi-drug resistant strains were from intensive care unit.
Resistant rates of Escherichia Coli ESBL, Klebsiella ESBL and Enterobacter spp to cephalosporins and penicillin were 100%. Resistant rates of staphylococcus aureus to antibacterial agents; cephalosporins and penicillin were 100%. Conclusion Gram-negative bacteria were the main multi-drug resistant bacteria of our study in our hospital, mainly distributing in Intensive care unit patients. They are highly resistant to most antibacterial agents, which provides a theoretical basis for the prevention and control of multi-drug resistant bacteria infection in hospital.

ХУРААНГУЙ. Дутуу төрөлт нь анагаах ухаан төдийгүй нийгэм эдийн засгийн тулгамдсан асуудал юм. Дутуу болон жин багатай төрөх нь нярайн эндэгдэлийн тэргүүлэх шалтгааны нэг болж байна. Шүдний тулгуур эдийн үрэвсэлт өвчний үед зарим нянгийн бүрэлдэхүүн хэсгүүд нь жирэмсэлтийн явц ба ургийн хөгжилд нөлөөлж болдог гэдгийг харуулсан судалгааны үр дүнгүүд байдаг. Иймээс жирэмсэн эмэгтэйчүүдийн тулгуур эдийн өвчин нь нярайн дутуу болон жин багатай төрөх эрсдэлт хүчин зүйл болж байгаа эсэхийг судлахад энэхүү судалгааны зорилго оршино. Уг судалгааг эмнэлэгт суурилсан тохиолдол хяналтын загвараар Нийслэлийн Өргөө Амаржих Газар болон Эх Хүүхдийн Эрүүл Мэндийн Үндэсний Төв (ЭХЭМҮТ)-ийн нийт 90 оролцогчийг хамруулан хийж гүйцэтгэлээ. Тохиолдлын бүлэг 30 (37 долоо хоногоос бага тээлттэй, 2500 гр-aaс бага жинтэй нярай) оролцогч, хяналтын бүлэгт 60 (хэвийн тээлттэй) оролцогч хамрагдсан. Судалгаанд оролцогчдийн шүд цоорох өвчний (ШЦӨ) тархалт хяналтын бүлэгт 99%, эрчим 8.32 ЦЛА/ш, тохиолдолын бүлэгт ШЦӨ тархалт 100%, эрчим 11.33 ЦЛА/ш байв. Амны хөндийн эрүүл ахуйн (АХЭА) үзүүлэлтийг үнэлэхэд хяналтын бүлэгт 2.4 буюу ‘’дунд’’, тохиолдолын бүлэгт 3.2 буюу ‘’муу’’ үнэлгээтэй байлаа. Тулгуур эдийн өвчин, шүдний чулуу (***p<0.008), шүд буйлны эмгэг хөндийн гүн 4-6 мм байх нь (***p<0.006) жин багатай дутуу нярай (ЖБДН) төрөх эрсдэлт хүчин зүйл болж байгаа нь статистик ач холбогдол бүхий үр дүнг үзүүллээ. Буйлны үрэвсэл нь ЖБДН төрөх эрсдэлийг 5.5 дахин нэмэгдүүлж байна. Community Periodontal Index of Treatment Needs (CPITN) үзүүлэлт нь АХЭА үзүүлэлтээс хамааралтай болох нь статистикийн хувьд ач холбогдолтой байлаа (***р<0.000). Тулгуур эдийн өвчин шүдний чулуу, шүд буйлны эмгэг хөндийтэй байх нь ЖБДН төрөх эрсдэлт хүчин зүйл болж байгаа нь судалгааны үр дүнгээс ажиглагдлаа.

Preterm birth is not only health problem but also one of major socioeconomic issues. Preterm Low Birth Weight (PLBW) is leading causative factor of neonatal mortality. Some researches results showed that during periodontal inflammatory disorder some bacterial components could affect pregnancy and fetal development. Therefore aim of our study is to assess and confirm periodontal disease of pregnant females whether or not risk factor of PLBW. We performed our study on the First Maternity Hospital and National Centre for Maternal and Child Health of Mongolia by clinical based case control method on 90 participants. Case group has 30 females (<37 weeks of gestation, and Neonates Birth Weight <2500), control group has 60 females (Normal birth) (ratio was 1:2). Dental caries prevalence on control group was 99%, the mean of DFM/t was 8.32 “average”, prevalence of case group was 100%, and mean of DFM/t was 11.33, which was also “average”. Oral hygiene examination assessment was poor. Study results showed that patients with periodontal disease such as dental calculus (***p<0.008) and periodontal pocket with depth of 4-6mm (***p<0.006) were risk factors for PLBW. Gingivitis is increased to have PLBW baby by 5.5 times. CPITN index was highly associated with dental hygiene index and it was statistically significant. (***p<0.000). Within the limits of this study poor periodontal health status of mothers may be a potential risk factor for a preterm low birth weight.

Backround: Hematology departments of health laboratories, over capital city and 21 provinces both of governmental and private sectors in this country, have to take responsibilities for providing hematology analysis. A wide range of technology and methods have been implemented among these laboratories. Harmonization of the hematology investigations of different laboratories with standard service all over the country is the major goal to reach. We organized the MEQAS (Mongolian External Quality Assessment Scheme) since 2008 on basis the Cooperation agreement between Ministry of Health and Sysmex Corporation in the establishment of Hematology external quality control and reference laboratory system in Mongolia. This is the report of our 8-year experience of MEQAS as the national project, covering increasing numbers of laboratory members. In 2008-2017 years we set up total 18 MEQAS in Mongolia. Materials and Methods:
Survey Materials
In each survey, the following three different of survey materials were used;
Sample A : Hematology Control Material 1*
Sample B : Hematology Control Material 2*
Sample C : Fresh Whole Blood Sample**
*Hematology Control Material provided by Sysmex Corporation
**Under cooperation of National Center for Transfusiology, a fresh whole blood sample was drawn from a healthy donor and prepared on the same day of sample delivery, according to the procedures reported by Kondo H et. all.
Standard Analyzers
3 units of fully-automated standard analyzers (KX-21, pocH-100i, XS-1000i), installed at the Shastin Central Hospital, were used to assign the target values for the survey materials. These standard analyzers have been calibrated with SCS-1000® before the survey, and monitored with hematology controls, e-CHECK(XS) ® and EIGHTCHECK-3WP® on daily basis.
Instructions & Sample Distribution
On every survey, the workshop was held to give guidance and distribute the survey samples to each participant.
Categorization of Peer Group
Participating data were divided into two peer groups, based on methodology; Group 1: laboratories used automated hematology analyzer (in further Auto’s), Group 2: manually examined group. Each laboratory was given ID number and was asked to analyze these samples 3 times and report the all data and average for CBC 8 parameters.
Statistical Evaluation Method
For individual reports, the results for each participant were evaluated and expressed according to peer group mean and standard deviation index (SDI), Precision index (PI), Absolute evaluation, Scoring system and Target-value evaluation methods (A B C D evaluation). Results:
The Auto’s inter-lab CV% of WBC for fresh whole blood showed decrease from 6.1 to 4.2 comparing with17^th and 18th MEQAS.
The Auto’s Inter-lab CV% of RBC for fresh whole blood showed decrease from 3.7 to 3.4 comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% of HGB for fresh whole blood were very stable (2.9%, 3.0%), respectively from 17^th to 18^th MEQAS.
The Auto’s inter-lab CV% HCT for the fresh whole blood showed go down from 5.5% to 4.8% comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% PLT for fresh blood showed go down from 10.2% to 8.2% comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% of CBC parameter for fresh blood and control Material (Sample A) showed go down from 1^st to 18^th MEQAS.
The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) were big difference comparing with Japan’s CV%. Conclusion:
1. The Auto’s inter-lab CV% of WBC, RBC and PLT for fresh whole blood has been decrease respectively 4.2%, 3.4%, 8.2% in the 18^th MEQAS and there was difference in the CV% between manufacturers.
2. The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) showed go down from 1^st to 18^th MEQAS but were big difference comparing with Japan’s CV%. Acknowledgements We would like to express our appreciation to the Sysmex Corporation (Japan) for providing financial supports investigate this study.

GoalTo evaluate the quality, results, and processing of cytology analyses of early detection program ofuterine cervical cancer implemented in Mongolia, which based on Pap test, at Ulaanbaatar city level.Materials and MethodsInformation was collected from the databases of the recalling system of screening program of theCancer registration and information unit of the NCC of Mongolia and districts pathology laboratoreis.Statistical significant level of 1.96 (95% CI) andthe margins of error 0.05 were considered andsample size was calculated by using the information that 10% of unsatisfied results appear onquality assurance of international level. Thus calculations were madefortotal of 1723 (585 positiveand negative 1138) samples, by collecting 287smears from each district.At the district level all the selected slides were reviewed blindly and compared to the previouscytological conclusion. Diagnostic validity was defined by calculating parameters such as specificityand sensitivity, positive and negative predicted values. The Kappa index criteriais used for statisticalcalculation of the cytological diagnosis conclusion matches.ResultsThe target group women coverage of cervical cancer screening program is 40.8%. Out of all positiveresults of early screening cytology, 77% were at an early stage and 23% were at an advanced stage.Thus positive signs were showed with increased detection results in early stage of uterine cervicalcancer (P = 0.05). Positive results of Pap test were follows; ASCUS (53.2%), ASC-H (10.0%), LSIL(19.2%), HSIL (13.4%), CIS (3.4%), and SCC (0, 8%). Out of total slides, 86.7% were as satisfactory.The test results conducted at the district level were90.1% of sensitivity, 88.8% of specificity and9.9% of false negative response. The discrepancy of results of cytology test in districts and repeatedseen is 31.4% (K = 0.749; p = 0.001).ConclusionThe coverage of cervical cancer screening program that has been implementing in our country isnot enough. There are problems at the district level including severe damages of uterine cervix andincomplete diagnosis. The quality of the cytology test is relatively unsatisfied.

In pathopsychology, one branch of mental analysis, recently we are using qualitative analyzing methods for mental phenomena. But improvement of professional methods of study, generalization of the new computer based technology, children’s psychology assessment and many other problems are becoming an urgent issue in this field.Our study involved 45 children from orphanage and the High School Personality Questionnaire (HSPQ) computer based questionnaire is used to measure the personality characteristics of orphan children. Spielberg-Hanin test is used to reveal anxiety. Study is analyzed by SPSS program.In total, 45 children (age from 9 to 18), 22 boys and 23 girls participated in our survey. 8.9% of them measured as a high intelligence, 91.1% measured as a lower and an average intelligence. Interestingly, 60% of children were good at controlling their emotions and behavior. Thus 55.6%had symptoms of flexible mind, imagining and probability of affect illness. Having more stress is due to introverted preference and self-blaming, also a feeling of self-blaming is due to not being bold. 51.1% of them assessed that they have dependent, emulative personality and submissive behavior which was very considerably. The anxiety of condition was high in 34.1% of children andlow in 12.2% of them, thus anxiety of individual was high in 36.6% and low in 7.3% of children. Therefore, it’s essential to help orphan children and consider reducing anxiety and improving their self-independence.

In 1992, the World Health Organization (WHO), developed a detailed set of criteria on oligophrenia diagnosis and differential diagnosis of clinically and recommends the methodology to test natural state of people’s psychology-intelligence development within the nation’s cultureand living environment and to define clinical characteristics. Thus, this study has been done upon the needs to localize some questions on IQ tests in close consideration of natural state of the Mongolians’ intelligence development within the nation’s culture.We had totally 340 individuals, who were sent by the stationary and ambulatory of the National Center for Mental Health, the Health Care Centers of Districts, the clinics in provinces, and Child Care and Protection Center for IQ tests as recommended by psychotherapists, as a target group and analyzed their test results with the WAIS test for defining their IQ levels.Totally 340 individuals of 15-58 year olds, including 178 males and 162 females were involved. According to the WAIS test, their IQ scores were between 32 and 120 with an average score: IQ=59.6%±0.8. According to the general knowledge scale test results, all the respondentseither from urban or rural areas were unable to answer two specific questions: “What is the name of the airplane inventor?” and “Who discovered the American continent?” out of the 25 questions in the test. Moreover, the 98.2% (n=334) of the respondents could also not answerthe question “What is the name of the Hamlet’s author?”.There were five respondents, who were able to answer the question and four of them were from the urban area. To the question “What centimeter is equal to 10 decimeter?” the 85% (n=289) of the respondents were unableto answer and the 92.2% (n=167, р=0,001) of the espondents from rural areas provided no any answer to the question.Test results are depending on the level of individual’s intelligence quotient (IQ). It is obvious that some respondents from rural areas more failed to answer the questions in, comparing to those provided by the respondents from urban areas. It would be caused anddirectly dependent on availabilities of information accessing sources, educational environment,and levels.

INTRODUCTION:In connection with request and financial assistance of Swiss Development Agency ‘’Mercury exposureand health impact assessment study among small scale miners in mercury free technology, wasconducted by researchers of Toxicology division of NCPH.GOAL:To determine mercury exposure level in biological samples of local small scale miners from mercury freetechnology introduced area. To reveal chronic mercury intoxicated patients,MATERIALS AND METHODS:Totally 147 artisanal miners from 33 cooperatives for small scale mining from Bayan-Îvoo soum ofBayankhongor, Bornuur sum of Tuv, Bayangol, Mandal and Tunkhel sum of Selenge province areparticipated in this study and the study was performed by cross sectional study methods during April toDecember, 2014.Over all 147 participants were in the first part of study, 60.5% out of 147 (89 participants) were in secondparts, and another 35.4% (52 people) were participated to the third parts of study. The participants wereundergone in to toxicological, dermatological and neurological examinations and the WHO guidance formercury exposure determination was followed in this study.RESULTS:On the results of all testing we revealed that there were 2 cases of chronic mercury intoxicated patientsfrom each Bayangol Bornuur soum, 2 from Mandal soum, and 3 from Bayanovoo soum.Overall 7 patientswere diagnosed as chronic mercury intoxicated and it comprised 4.7%of (n=147) all involved participants.We have observed that average height of total medical examination number was (2.9) in Bornuur soum.It indicated that there will have higher number of patients would exist in Bornuur soum than others.Ourstudy result has shown that neurological symptoms like tremor and imbalance were more diagnosedamong participants from Mandal and Bayngol soums. It implies that the health of the small scale minersfrom this soum more affected and needed to be investigating further.CONCLUSIONS:Mercury is still being used among artisanal gold miners even thoughit is still illegal. Further medicalevaluation and assistance needed to be taken for newly diagnosed 7 patients.

In modern society there is an increasing demand for oral communication in many professions. Professional voice users aren’t limited to teachers, ministers, salesmen, telemarketers, telephone operators, actors, singers, radio/TV announcers and attorneys. Problems reported by professional voice users are varied and may include hoarseness, voice breaks or cracks, voice loss, weak voiceand vocal fatigue. There are no studies done about the professional voice users in Mongolia. The purpose of this research that was to examine loading effect of work and additional loading factors. We were studied about comparison between normal groups and voice changes groups. Ninety seven professional voice users participated in this study. Half had singers group and half were found to haveteachers group. We used to the voice handicap index (VHI ) score and videolaryngoscopy and other general questionnaire.We studies voice change of the 97 professional voice users. We diagnosed voice disoeders by videolaryngoscopy and voice handicap index. We collected the data base in SPSS 22 and Microsoft excel programs.Major risk factor for voice change was use hormonal medicine. From 97 patients were predominantly diagnosed disease 14,4% reflux laryngit, 15.5% vocal fold nodule, 23.7% acute laryngit. Most of the patients had mild levels changes of voice handicap index.Voice disorders are common in professional voice users. So steroid use increase the risk of voice disorder in professional voice users.