Background : Diabetic ketoacidosis, an early and common complication at the initial diagnosis of Type 1 Diabetes Mel litus (T1DM), remains a significant clinical concern. The high prevalence of this complication in the pediatric population provided the rationale for conducting the present study. Aim: Our study aims to compare the incidence, clinical features, and physical measurements associated with diabetic ketoacidosis (DKA) at the time of initial diagnosis of Type 1 Diabetes Mellitus (T1DM), and to classify the severity of DKA based on selected laboratory findings. Materials and Methods: We conducted a retrospective observational study of newly diagnosed T1DM with DKA in children aged less than 18 years old at National Center for Maternal and Child Health during the period 2017-2022. The study compared the analysis of medical and laboratory records from patients medical charts. The severity of diabetic ketoacidosis (DKA) was classified based on laboratory criteria according to the 2022 guidelines of the International Society for Pediatric and Adolescent Diabetes (ISPAD). The study data were analyzed using STATA-16.0. Results: During the period from 2017 to 2022, a total of 124 children under 18 years of age (mean age: 9.11±3.84 years) were newly diagnosed with T1DM and included in the study, of whom 67.7% (n=84) presented with diabetic ketoacidosis (DKA). Of the children with DKA, 57.2% (n=48) had severe, 17.8% (n=15) had moderate, and 25.0% (n=21) had mild severity. Girls were more frequently affected (67.1%, n=47; p=0.871). Having a viral infection before the first diagnosis of type 1 diabetes (51.2%, n=43, p=0.011) and having high blood glucose levels at that time (25.8±9.32 mmol/l, p=0.012) were statistically significantly associated with diabetic ketoacidosis. The blood gas analysis of children with ketoacidosis showed pH 7.05±0.15, HCO3 8.68±4.27 mEq/l, and the group with severe ketoacidosis had higher blood potassium levels (4.08±0.8 mEq/l, 3.6±0.56 mEq/l, p=0.049) and blood glucose levels (28.37±9.23 mmol/L, 21.96±9.18 mmol/L, p=0.012) compared to the group with mild ketoacidosis. Conclusions 1. Diabetic ketoacidosis (DKA) was identified in 67.7% (n=84) of the children included in the study. 2. At the initial diagnosis of Type 1 Diabetes Mellitus (T1DM), vomiting and fatigue were the predominant clinical manifestations of DKA. 3. Severe DKA was observed in 57.1% (n=48) of the participants, with elevated serum potassium and glucose levels noted as contributing factors to the severity of ketoacidosis.

Introduction: In 2020, about 3% of children and 5% of adolescents had metabolic syndrome, with some variation across countries and regions. The prevalence of overweight and obesity among children and adolescents aged 5-19 years has increased sharply from only 8% in 1990 to 20% in 2022. 3-5% of children and adolescents have hypertension, 10% 14% have changes in arterial pressure, and the prevalence has increased from 1.3% -6.0% These risk factors can lead to MetS, and although there are several studies by national researchers in adults, research on risk factors for MetS in childhood is rare. Aim: To evaluate the physical growth of children aged 6-17 and study the risk of metabolic syndrome (MetS) among them. Materials and methods: A family health center-based, cross-sectional survey was conducted in the apartment district and ger district of Ulaanbaatar, using standardised measurement tools. A total of 622 participants aged 6-17 years were included in this study. Body weight, height, waist circumference, arterial blood pressure, and blood glucose of the participants were measured and the results of body measurements were estimated using the growth chart. Results and conclusions Among the participants, 48.2% (n=300) were male, 51.8% (n=322) were female. The rate of overweight and obesity among the study population is 20.26%, and male children are 2 times more obese than female children. 7.23% of the study participants. The prevalence of metabolic syndrome was 1% with 3 risk criteria according to the IDF 78.93% (n=491) have no risk, 19.33% (n=121) have 1 risk, and 0.48% (n=4) have 2 risks. Among the studied risk factors for metabolic syndrome, overweight, obesity, and central obesity were the predominant risk factors among children. One in five children is either overweight or obese, with boys being twice as likely to experience these conditions (p<0.001). In 1% of the study participants, metabolic syndrome with three risk factors was identified. Overweight, obesity, and metabolic syndrome were more prevalent among the 15-17 age group compared to other age groups (p<0.001).

Purpose: To investigate the outcomes of ROP screening of retinopathy of prematurity (ROP). Methods: This was a prospective of prematurity infants screened ROP from 2020 April 13th to April 28th 2020 and from 2020 June 08 th to June 22th 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery. Demographic factors, diagnosis and clinical course were recorded. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were taken. Each eye was evaluated by the pediatric ophthalmologist and aimag’s 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 Results: A total of 90 premature infants with BW ≤ 2000g and/or GA ≤ 34 weeks were screened for ROP during the study period. 8 (8.8%) of the 90 infants screened required treatment. The 8 infants who received ROP treatment had a mean GA of 28.5 ± 1.7 weeks, mean BW of 1237.5 ± 125.42g, mean PMA of 36 weeks and mean follow-up time of 2 months. Conclusion After treatment, resolution of ROP was noted in approximately 100 % of the patients who had treatment-requiring ROP.

Introduction : Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that occurs during childhood development, which presents with signs of reduced attention and hyperactivity [1]. Necessary nutrients, such as trace minerals, including manganese, iron, zinc, iodine, selenium, copper, and chromium, are associated with changes in neuronal function that can lead to adverse effects on behavior and learning [2]. In addition to these, social, emotional, behavioral problems, and cognitive impairments such as executive dysfunctions are common in ADHD [3]. Goal: To evaluate the hair elements and intelligence quotient in children with ADHD. Materials and Methods: This is a cross-sectional comparative study conducted at elementary schools of Ulaanbaatar city. All in all 60 children of both genders aged between 7-12 years old were included in the study. Children were divided into two groups as children with ADHD group and a control group. Each group had 30 children. For assessment of emotional Intelligence EQ-i:YV - Emotional Quotient Inventory: Youth Version (Bar-On & Parker, 2000; it ad. Sannio Fancello, & Cianchetti, 2012) was used. Scalp hair samples were randomly collected from approximately ten sites around both sides of posterior parietal eminences and external occipital protuberance. Samples were then packed at room temperature and submitted for laboratory analysis. The study was approved by the Research Ethics Committee of Mongolian National University of Medical Sciences (Reg. No. 2018/Д-10). Results: The IQ of children with ADHD group were 85.03±16.86 p<.0001 and the IQ of control group =108.9±21.22, p<.0001. We identified hair minerals such as Mg, Zn, Pb, Se, Mn. We have then compared to each group and normal ranges of ages. ADHD group and the control group had Pb concentration that was slightly higher and inversely Mg concentration was slightly lower (r=-0.502, p=.005). Concentration of Pb, IQ were directly opposite (r=-0.38, p=.03). Conclusion
1. IQ was lower in the ADHD group compared to control group 85.03±16.86 p<.0001, monitored group 108.9±21.22, p<.0001.
2. The group with ADHD had lower Mg, Zn, and higher Pb, Se, Mn (p<.0001). The IQ decreased when there was increased Pb and decreased Mg.

Glucose-6-phosphatase dehydrogenase (G6PD) deficiency is the most common enzyme deficiency in humans, affecting 400 million people worldwide and a high prevalence in persons of African, Middle Asian countries. The most common clinical manifestations are neonatal jaundice and acute hemolytic anemia, which is caused by the impairment of erythrocyte’s ability to remove harmful oxidative stress triggered by exogenous agents such as drugs, infection, or fava bean ingestion. Neonatal hyperbilirubinemia caused by glucose-6-phosphate dehydrogenase (G6PD) is strongly associated with mortality and long-term neurodevelopmental impairment. Aim:To determine a level of glucose-6-phosphate dehydrogenase in healthy neonates.The 76.5% of all participants (n=205) was assessed 4.36±1.15 Ug/Hb in normal reference range of G6PD other 23.5% (n=63) was 0.96±0.51 Ug/Hb with G6PD deficiency. In the both sex, 51.5% of male 0.88±0.46Ug/Hb (n=33) and 47.6%of female (n=30) 0.97±0.55Ug/Hb was assessed with G6PDdeficiency. Developing Jaundice period in number of 63 neonates with G6PD deficiency, 85.7% of neonates (n=54)was in 24-72 hours, 4% of neonates (n=3) was in 5-7 days and there is no sign of jaundice in 9% (n=6).Therefore neonates with G6PD deficiency, 53.9% (n=34)contiuned jaundice more than two weeks.G6PD deficiency was determined in male neonates (51.5%) more than female(47.6%). The 76.5% of all participants (n=205) was assessed 4.36±1.15 Ug/Hb in normal reference range of G6PD other 23.5% (n=63) of all participants was 0.96±0.51 Ug/Hb with G6PD deficiency. It shows that G6PD might be one potential risk of neonatal jaundice and hyperbilirubinemia in neonates in Mongolia.

BackgroundMonos Pharm LLC has been started production of Dentamon which is an elixir medicine for gumtissues and a oral cavity inflammation and consumer product has been under appreciated today since1998. Now days, as the technology develops, improved levels of consumer demand for consumptionand they want the product easier to use. In this study, sustainable refers to both the technology andstandardization characteristics of gel medicine for a new Dentamon or Dentos gels were prepared using20% ethanol extract for mixture of Chamaenerion angustifolium L, Stellera chamajasme L and Oxytropispseudoglandulosa which are pharmacological active for gum tissues and a oral cavity inflammation.GoalThe aim of this work was to standardize of Dentamon elixir gel medicine and make technological studyof Dentamon.Materials and MethodsThe present study included plant species which were Chamaenerion angustifolium L, Stellerachamajasme L and Oxytropis pseudoglandulosa. Those three medicinal plants were collected fromdifferent regions of Mongolia and samples their upper part of ground. The plants were used for thepurpose of their phytochemical analysis and technological study of gel formulation. For the contentof flavonoids, total coumarin and tannin in the gel and extract of those plants were determined byspectrophotometric method. The direct measurement of the microbiological climacteric was determinedin extract by according to Mongolian National Pharmacopeia and the viscosity property of gel medicinewas identified using viscometer.ResultsThis study has revealed the presence of photochemical considered as active medicinal chemicalconstituents. Chemical tests of the screening and identification of main active components in the plantsunder study were carried out in the ethanol extract (20, 40, 70%) and aqueous extract using generalextraction method. The tannin content of the upper part in water and three different concentrated ethanolextract was found to be (2.16±0.04%, 1.73±0.04%, 2.58±0.04% and 1.74±0.02%), respectively. Thetannin content of upper part in 40% of ethanol extract of the plants was 7.40±0.21% and coumarin contentwas 3.01+0.09% and the total flavanoids content were 0.70+0.03%. There were not detected Esherichiacoli, Salmonella, Pseudomonas aeruginosa and Staphylococcus aureus in plant extracts. The gelmedicine was prepared from concentrated plant extract using dispersion method and and gel formingmaterial selection using 0.5%, 1%, 1.5% and 2% of carbomer. The results from gel formulation assay,the 0.5% of the gel was turbid liquid state, and 1% of the gel was a colorless, clear liquid state, 1.5% gelwas colorless, created very clear and 2% gel was colorless but it was very dense. The pH condition ofthe 1% of Dentos gel was 7.6 and the viscosity property was 7400000 mPa/sec, the flavonoid contentwas 0.165%, the total coumarin content was 0.69 and Pseudomonas aeruginosa, Staphylococcusaureus, Enterobacteriaceae did not detected. Dentos 1% gel was compared its pharmacological trialwith Hi Ora gel which is produced by Himalaya LLC. On the treatment 14 days, Dentos gel more reduced45.9% of wound area index than Hi Ora gel.ConclusionThe 40% ethanolic extracts of the studied plants contained many bioactive chemical constituentsincluding alkoloids, flavonoids, tannin and coumarin. The 1.5% of carbomer was most effectivefor make a new Dentos gel and also new generated gel was most effective against Pseudomonasaeruginosa, Staphylococcus aureus, Enterobacteriaceae. The new generated gel was standardizedby its appearance, viscosity property and content of coumarin, alkaliod, flavonoids and microbiologicalpurity characteristics.

Background. The main target of this research paper on “Some issues relating to the family healthcenter, family doctors care and health services” is for the young doctors, and specifically family doctorsand to help their daily work routine. This paper focused on giving analyses on the principle of somescholars research paper about the general structure of family health center, and its practical activities.There are many issues related to social medical service, an example is the basic health service fromthe family health center. There must a model or classic form for providing medical service at the statefamily health center, general medical center and the first care of medical center. This research paperalso proposed a number of current issues in order to improve the quality, such as family health centerand its management structure.Goal. The reference of this paper is to define family health center service and financial management,based on the research survey. Moreover, it concludes the idea of improving and refreshing the healthsector from the smallest branch and implementing health care marketing in the public. This researchpaper contains followings: the structure of family health center, health insurance, medical service costper person in the family, training for family health center doctor and nurse, the history of family healthcenter origin and its development, home visit service, foreign countries experience on this sector, andthe system to simplifying II, III level medical service etc.Materials and Methods. In our country Mo.Shagdarsuren has changed section hospitals into familyhealth hospital who is doctor, one of the famous manager of health protection who is firstly managed cityUlaanbaatar to committee and district. In early 1990s doctor Ts.Mukhar organized control system of familyhealth in some sub cities who helps people to get better health program. He organized small hospitalitysystems of each sub cities and moved kids doctors to family health system. Since its establishment,the system was rapidly extending throughout the country. Researches for changing the management ofFamily Health Center (Udval.D, Bat Ochir.D) and for the future development of family hospital (Mukhar.Ts, Orgil.B) are proven to be useful in practical environment.Result. The importance of this advisory article is considering in improving the Family Health Careservice sufficiency and its quality coordinating with the writings or publications written by ourcountryfamous scientists. Health Sector reformation strategy and other materials to clarify the importanceprimary health care importance of the family health care and its doctors and it is necessary to hire thebest and most experienced doctors and social health figure in hospital primary service in modernsociety.Conclusion. In conclusion, the scholars believe that in this society, the doctors who are the best, mostexperienced, well- educated on general and family health center service, and trained well, work fromtheir bottom of heart, number of accident, and disease rate will gradually decrease. Therefore, thefacilities of the health center must be improved such as providing proper workplace with well equippedmedical facilities and medical diagnosing cameras etc.Additionally, known as “The left hand of a physician“ in other words, there is a high demand to preparewell educated, professionally independent and knowledgeable nurses for the family health center

IntroductionThe aimag health statistics of 2009 shows that the cancer morbidity is 24.94 per 10000 populations,which is 1.6 times and the cancer mortality is 21.48 per 1000, 1.8 times higher than the national average respectively. Therefore, this research was carried out to study the KAP on breast and cervical cancers among the women of Sukhbaatar aimag for planning and implementation of actions meeting their needs.MethodologyIn total 570 women from Bayandelger, Dariganga, Ongon, Munhkhaan and Erdenetsagaan soums and 2 baghs of the aimag centre were involved in the study by random sampling.ResultsIn the study involved 570 women of 6 soums of Sukhbaatar aimag. The average age of the women is 33 1.0. Women with university education are 21.4%, with complete secondary education 44.3%, with incomplete secondary education 3.3%, with primary education 7.7%, and uneducated was 1.1%. Herding women composed 22.8% of the participants. The knowledge related to the age of the participants demonstrate higher level of knowledge on cancer among 35-44 year old women. By thereasons of involvement in the breast screening, 68% have not been examined in last 5 years, 10% have visited voluntarily and the rest participated as it was organised by their employees or by chance. The average score of the knowledge on cervical cancer was 7.8 or 30%. The women themselves assessed their knowledge on cervical cancer as poor. The responses given by respondents in the study of the signs of the cancer also demonstrate low level of knowledge. Also the women’s knowledge on early detection of the cancer is insufficient. The knowledge, attitude and practicce of local women concerning breast/cervical cancer, the factors affecting the screening, current needs and the level of health education were defined by this study and the findings of the study show that it is necessary to focus on improving the KAP of the target population on preventive acctivities and participation in screening and enhancement of related trainings.Conclusions:1. The knowledge of the women on breast and cervical cancers is generally low.2. The sources of information on the causes of breast and cervical cancers are scarce.1. The insufficient KAP towards screening and poor preventive behavior negatively affect early diagnosing of breast/cervical cancer.

BackgroundRestoring and reestablishing the Hospital Management and Organization Sector in the Institute of Medicine since 2010 was the significant organizational measure in the framework of the social health annual action that is of particular value getting researchers of medical research institutions and physicians and scientists of urban and rural area medical sectors involved in the activities to conduct the compilation survey on general situation of population sickness, its rate and on reducing the noncommunicable diseases rate and death rate making doctors and officials of the medical sector to worry about. Furthermore, the goal and objectives of the Hospital Management and Organization Sector of the Institute of Medicine will be directed to conducting the comparative survey “conjuncture” on the total sickness and statistical report registered at the national polyclinic, medical units and family hospitals of urban and rural area, realizing the innovation issuing recommendation and introduce the result in the practice of medical institutions.Summary and recommendationWriting on principal reasons of non- communicable diseases rate and death rate collecting data from the statistical survey summary in the framework of activities of the Institute of Medicine will be significant work for the activities of all physicians, scientists and researchers of whole health sector in making constant the research work in the future, conducting the complex prophylactic policy and expanding the practical measures of the result from the one hand and in realizing the annual goal and objective of social health from the other. As well as it was very significant in working out the research project regarding the non- communicable diseases rate in higher quality by the Sector for Social Health, Hospital Management and Organization of the Institute of Medicine, making conclusion on whole efficient result meeting the requirement and realizing it in future activities in reality.This time, we conducted the comparative survey on the population’s sickness situation and noncommunicable diseases rate by the compilation method and particularly the comparative survey on principal reasons of the sickness and their structure and submitted to publish. Furthermore, according to the tradition of previous generations, the Hospital Management and Organization Sector of the Institute of Medicine will organize the comparative survey on reducing and preventing the noncommunicable diseases rate and death involving the urban and rural medical institutions in these surveys and widely promote it through the media and theoretical and practical conferences.

BackgroundThe works done during the research include: conducting photochemical study on the surface of the piece of land on which the medicinal herbs chosen as samples for the research grow; extracting dry infusion from plants; identifying main substance and antibacterial activity of dry infusion; conducting pilot pharmacological experiment with mineral samples.GoalBased on the results of these experiments, we aimed at finding out wound healing functions of Chelidonium majus. L, Stellerae chamaejasme.L etc, widely used in both conventional and modern medicine as well as of such minerals as Sinder, Zeolite, Tormohon, Baragshun after selecting from them.Materials and MethodsAlkaloid, a biologically active substance found in surface of plant land and dry infusion, was determined by titration method, alkaloids such as protopine and berberine by high performance liquid chromatography, coumarin and flavonoid by spectrophotometric method, the amount of infusible substance by scale method. The methodologies of Gatsura.N and Avtandilov.G.G were adopted to make artificial wound on skin and to heal a wound respectively.ResultsAs the research result shows, the surface of the area where Stellerae chamaejasme.L grow, contains 0.33% ±0.004 total coumarin, 0.19 % ±0.002 flavonoid and 37.14 % ±0.61 infusible substance while that of Chelidonium majus.L contains 0.19% ±0.003 total alkaloid, 0.12 % ±0.004 flavonoid, 0.09 % ±0.002 coumarin and 36.27%±0.74 infusible substance. After the infusion was extracted from Stellerae chamaejasme.L and Chelidonium majus.L through method of percolation with mixer, there were 16% and 14.5% dry substance remained in the infusions respectively. These figures were reduced to 12.6% and 11.4% after freezing them in -500C for 72 hours in dry freezing. The fact that total coumarin contained in dry infusion of Stellerae chamaejasme.L is 2.95% and protopine and berberine in that of Chelidonium majus.L, is 28 мг,% and 3.7 мг,% respectively meets the requirements for medicinal plant extracts. It was found during the pharmacological experiment of preparing 25% oil ointment composed of minerals including Sinder, Tormohon, Zeolite, Baragshun that zeolite was the highest effective mineral in healing a wound by wound index. Therefore, we chose zeolite as an ingredient of the wound ointment. Oil ointments of 6 variations with 5% and 10% content were prepared from the dry infusion as well as minerals of the study plants, and pilot pharmacological experiment was conducted on an experimental mouse that had an artificial wound. The result of the experiment proved that oil ointments with 5% content of Stellerae chamaejasme.L, Chelidonium majus.L and zeolite were more effective in healing the wound than others.ConclusionBy photochemical analysis, the chosen plants proved to be meeting the requirements for medicinal plants. Pilot pharmacological experiment showed that zeolite was the one that accelerated a wound healing process more efficiently than others. Oil ointments with 5% content of dry infusion and 5% of zeolite were effective in healing a wound quickly.