Early detection of bronchial asthma in children and establishment of a national continuous monitoring system Introduction: Bronchial asthma - a chronic inflammatory disease with recurrent allergic reactions characterized by increased sensitivity of the bronchi to various factors, swelling of the bronchial mucosa, excessive mucus secretion, and narrowing of the airways due to severe muscle contraction. Early detection of bronchial asthma in childhood, its prevalence, and the establishment of a continuous monitoring system to assess the effectiveness of follow-up treatment Materials and methods: It is mild in children, but is ready to be severe. If left untreated for a long time, the structure of the bronchi changes irreversibly and becomes ineffective. There are cases of death due to risk factors for irritability and asthma. In the first objective of the study, the National Center for Maternal and Child Health (NCMCH) Children's Counseling Polyclinic, Respiratory Pathology Department, and the Children's Department of the General Hospital of 21 aimags and 9 districts were used to determine the prevalence of Acute respiratory infections, implemented outpatient (2019-2021). Within the scope of objectives 2 and 3 of the study, a self-controlled case-control study model was used to assess the diagnosis of asthma in the case group based on the GINA-2018 guideline evaluation and clinical and laboratory tests based on the GINA protocol treatment. The parameters were taken, the pre-treatment parameters were recorded and compared in the control group, and the results were calculated. Results: When the prevalence was determined by the Acute respiratory infections level, there were 11 cases per 1,000 children. 80.8% of cases of asthma were caused by asthma 1-5 times a year, and the majority or 96.5% were aged 0-9 years. Allergies include plant (42.9%), food (25.4%), and pet (14.3%) allergies under the age of 4, all types of allergies between the ages of 5-14, and plant allergies 15-19 years, (9%), food (21.4%), pet (14.3%), environmental moisture and mold allergies (14.3%). Among the 89 children treated according to GINA guidelines, 64.0% used spices or allergenic foods, 13.5% used antibiotics, 6.7% used paracetamol, and 13.5% used other drugs. Children with asthma were assessed according to GINA guidelines and monitored and treated for 1 year (0.0001), the number of cases of asthma (p = 0.035) and the number of people receiving emergency care (p = 0.042) decreased statistically. There was a statistically significant difference of 2%, nocturnal cough decreased by 15.2%, and whooping cough decreased by 1.4%. Conclusions: The prevalence of asthma was 11 cases per 1,000 children. The main causes of allergies are plants, food and pets. The number of coughs, hospitalizations and emergency room visits decreased with GINA treatment.

Purpose: Kidney function assessment method is improving gradually. New biomarkers are studied and started using in clinical practice, such as beta 2 microglobulin. Beta 2 microglobulin is improving diagnostic and prognosis in CKD patients. We aimed to assess convenience usage of B2MG alone and B2MG based eGFR in Mongolian patients. Materials and method: We included 116 patients diagnosed with CKD and 55 donors whom with normal kidney function. We collected participant's blood sample by venipuncture in plain vacutainer. Creatinine, urea, cystatin C, B2MG were tested by Roche Cobas C311 equipment in serum. eGFR was calculated by online calculation from NKF. B2MG based eGFR was calculated by eGFR=133*B2M^-0.852 Result: Assessment of kidney biomarkers and eGFR was significantly correlated in both groups. Measured serum creatinine was 3.37 mg/dl in CKD patients and 0.87 mg/dl in donors. Serum urea was 97.6 mg/dl, 31.1 mg/dl, cystatin C 3.05 mg/L, 1.49mg/L and beta 2 microglobulin 10.65 mg/L, 2.43 mg/L respectively. Estimated GFR was 21.5-28.4 ml/min/1.73m2 in CKD patients and 47.7-103.9 ml/min/1.73m2 in donors. Assessing kidney function by biomarkers (r=0.720-0.918, p<0.05), and eGFR (r=0.495-0.996, p<0.05) were significantly correlated in both groups. Conclusion B2MG can be used in clinical practice in Mongolia. B2MG is optional with creatinine, urea, cystatin C for assessing and improving kidney function.

Background:Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on long-term graft and patient survival.Objective:Our aim was to assess the long-term graft and patient survival rate correlation with HLA-A-B-DR matching. Material and Methods:We retrospectively analyzed data from 70 adult kidney transplants performed at our hospital from August 2006 through January 2014. The data was retrospectively collected from patient fles, including characteristics of the recipient and donor, post transplant features and HLA-A-B-DR DNA based typing results. The KaplanMeier method was used to analyze graft and patient survival.Results:The mean patient follow-up period after kidney transplantation was 39,6±25.9 months, and the mean kidney graft follow-up period was 36.6±23.7 months for 70 cases. Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%) respectively in 70 cases. Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%) respectively in 34 cases. The group with four to six mismatched were found to have a signifcantly lower 3 and 5-year graft and patient survival (71%; 35%); (80%; 40%) compared to 0 to 1 mismatched group (100%) (p=.030; p=.015). Furthermore we analyzed the association of HLA matching, immunosuppressive therapy and long-term graft survival. We selected CNI mono-therapy group for long-term survival analysis and observed a similar pattern. In mono-therapy group, the group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (75%; 30%); (65%; 30%) compared to 0 to 1 mismatched group (100%) (p=.037; p=.001).Conclusion:The results showed that graft and patient survival rates were lower compared with results from established centers. Statistically highly signifcant effect of HLA matching on kidney graft and patient survival rates was found in our analysis. Five years after transplantation the graft survival rate of frst adult kidney transplant with 4-6MM was 65-70% lower than that of grafts with 0-1MM. Longitudinal cohort study needed in the future to exhibit an improved transplantation outcome.