Background: Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults. Materials and Methods: Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B₆, B₉, B₁₂ and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B₁₂ in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B₁₂ was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B₉ was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B₆, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. Conclusion The reference values for vitamins B₆, B₉, B₁₂ and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.

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.

Background: Minerals are important for the proper body functioning. They also play a role in preventing and fighting diseases. Reference values for minerals help physicians evaluate the mineral status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some minerals to be used for evaluation of the nutrition status of Mongolians. Materials and Methods: Two hundred and forty healthy adults (120 males and 120 females) of 17 to 70 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the ethical committee of the Ministry of Health of Mongolia. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of iron (Fe), zinc (Zn) and copper (Cu) were measured by graphite furnace atomic absorption spectrometry. The lower and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean level of blood iron was 30.50 µmol/L (95% CI 29.71-31.29) for men and 30.91 µmol/L (95% CI 30.03-31.79) for women. The calculated reference interval for males was 21.39-37.72 µmol/L and 19.87-39.67 µmol/L for females. The mean concentration of zinc in the blood of males was 11.00 µmol/L (95% CI 10.69-11.31) and that of females was 11.79 µmol/L (95% CI 11.39-12.19). The reference interval for blood zinc was 8.20-14.92 µmol/L in men and 8.52-16.67 µmol/L in women. The mean level of blood copper was 15.28 µmol/L (95% CI 14.64-15.89) for men and 18.08 µmol/L (95% CI 17.30-18.86) for women. The calculated reference interval for copper in males was 9.72-22.34 µmol/L and that in females was 11.18-27.27 µmol/L. Conclusion The reference values for zinc, copper and iron of Mongolian adults do not differ significantly from those observed in other countries. The calculated reference intervals can be used for evaluation of the nutrition status and making clinical decisions.

Background: We set the average value and reference range of blood plasma proteins (total protein, albumin, transferrin, retinol binding protein, prealbumin) to be used to assess the nutritional status of Mongolian adult. According to step by step research methodology, 170 women, 170 men and a total of 340 people were surveyed using a combination of questionnaires and analytic methods. Methods: The total protein and albumin content of the collected samples was analyzed by colorimetric method using “Humalyzer 2000” semi automatic analyzer and prealbumin, transferring and retinol binding protein was analyzed by ELISA method of “ELX 880”. The lower limit of the reference value of the identified parameters was calculated to be 2.5 per centil and the upper limit was 97.5 per centil. Results: Determining average and reference range of proteins in the plasma of a total 340 participants, the average of total protein was 74.54(CI 95%; 72.67-76.38) g/l for men, and 73.59(CI 95%; 72.39-74.79) g/l for women, while the reference range was 55.26-95.79 g/l for men and 58.38-84.72 g/l for women. According to determined above, there is no statistically significant difference in gender (p>0.40). The average albumin level is 48.20(CI 95%; 47.04-49.36) g/l for men and 46.28(CI 95%; 45.32-47.24) g/l for women, while reference range is 37.14-60.01 g/l for men and 34.97-57.60 g/l for women. It means there is a statistically significant difference for the gender (p=0.012). The average prealbum level is 332.43(CI 95%; 311.28-353.58) mg/l for men, 381.67(CI 95%; 360.98-402.36) mg/l for women, while reference range is 171.3-485.0 mg/l for men and 215.5-535.0 mg/l for women. It means there is a statistically significant difference for the gender (p=0.0012). The average range of transferrin 4.01(CI 95%; 3.76-4.26) g/l for men and 4.43(CI 95%; 4.20-4.66) g/l for women while reference range is 2.20-6.92 g/l for men and 2.58-7.05 g/l for women, is a statistically significant difference for the gender (p=0.017). The average level of retinol binding protein is 1.73(CI 95%; 1.61-1.85) μmol/l for men and 2.01(CI 95%; 1.89-2.13) μmol/l for women, while reference range is 0.73-3.08 μmol/l for men and 0.73-3.08 μmol/l for women, is a statistically significant difference for the gender (p=0.0017). Conclusions For the first time we conducted a study to determine the average amount and reference range of proteins needed to assess the nutritional status of adults (total protein, albumin, prealbumin, transferring, retinol binding protein) according to international standard methods, which is relatively high compared to other researchers. According to the result of the study, it is not possible to directly follow the result of researchers from other countries and the reference range of blood proteins directly to Mongolians. The result of this study has become an important innovation in practice and treatment, as medical professionals have been able to use it in their diagnosis and treatment.

Background: Screening programs for the detection of inherited disorders of amino acid metabolism is mandatory in most countries. Various laboratory methods are used for this purpose. We tested a high-performance liquid chromatography method for the separation of amino acids in blood and urine samples. Materials and Methods: All reagents were of the HPLC grade purity,water used for t he analysis was deionized and reagents and samples were ultrafiltrated using a micropartition system.
The analysis was performed using the HPLC system with two pumps, a C18 column and a UV detector. All evaporations were done using a vacuum concentrator.
Amino acids were derivatized using a solution of ethanol, water, triethylamine and phenyl isothiocyanate. The amino acid derivatives were separated using a linear gradient with two solvents: solvent A (sodium acetate : acetonitrile) and solvent B (water : acetonitrile).
Amino acid standards of 20, 50, 100, 200, 500, 750 and 1000 µM were prepared in 1 mM hydrochloric acid.
The EDTA blood as well as urine samples were spun at 1500 g for 15 min and then ultracentrifuged at 1500 g for 30 min. Results: Experiments with various chromatographic conditions showed that factors which influenced the amino acids separation were the type of columns, mobile phase composition, flow-rate, gradient programs and timings.
After studying the effects of changes in individual parameters of chromatographic conditions, the following method parameters were chosen: pre-column derivatization agent –PITC, separation column – C18, mobile phase –solvent A: sodium acetate : acetonitrile (98:2) and solvent B: water : acetonitrile (40:60), gradient – linear, flow-rate – 1.2 mL/min. With this method 22 amino acids were separated within 35 minutes. Conclusion The developed method is simple and can be used by medical laboratories for the detection of inborn errors of amino acid metabolism.

Background: Iodine deficiency may result in a goiter, developmental delays and other health problems. The simplest way for the iodine deficiency prevention is consumption of iodine-rich food products. In our country, the iodine consumption is supported by edible salt iodization. Human organism excretes 80% of iodine with urine, therefore the urinary iodine level is considered as an indicator for the iodine status of an individual. Goal: The goal of our study was to evaluate a correlation between the levels of iodine in salt and in urine. Materials and Methods: 2173 samples of household salt and urine samples of 1697 school-age children were collected covering 20 aimags and Ulaanbaatar city. Levels of iodine in the salt samples were determined using a titration method, and for the determination of iodine concentrations in urine the SandellKolthoff’s reaction was used. The correlation between two sets of values was assessed with Pearson’s correlation coefficient. Results: The sample collection was organized so that the aimags were divided into 6 to 8 clusters, each cluster comprising 12 to 15 households or children. Therefore, average values of the iodine concentrations in salt and urine of each cluster were used for the correlation assessment. The result of the statistical analysis showed a high variation in correlation between salt iodine and urinary iodine at the aimag level, but the overall correlation at the country level was strong positive (r=0.7). Conclusion The hypothesis that the correlation between the iodine amount excreted by children from a certain location and the level of iodine in salt consumed by households in the same location is strong, was not confirmed at the aimag level, but the correlation was strong positive at the country level.

Justification: Iodine is a micronutrient essential for human health. 92% of the required iodine human organism obtains with food. One of methods to supply the required amount of iodine is the use of iodised salt. The overall goal of our study was to determine the actual consumption of iodised salt by households. Materials and Methods: Samples of salt consumed by 20173 households from five regions (Western, Mountainous, Central, Eastern regions and Ulaanbaatar city) of Mongolia were collected and their iodine contents were determined according to MNS 5168:2002. Results: Out of the total analyzed salt samples, 19.1 % were non-iodised, 2.8% had low iodine content, 77.5% had appropriate level of iodine and 0.6% had high level of iodine.
When the salt iodine contents were evaluated by the country regions, it was revealed that the households in Western (31.4%) and Mountainous (20.57%) regions consumed salt that was not iodised. 84.5% of the Ulaanbaatar city households consumed salt with appropriate level of iodine. Conclusions
1. 19.1 % of the surveyed households consume non-iodised salt, 2.8% consume salt with low iodine content, 77.5% consume salt with appropriate level of iodine and 0.6% consume salt with high level of iodine.
2. The iodine level is appropriate in 84.5% of salt consumed by Ulaanbaatar city households.

Background: Iodine is a micronutrient essential for mental and physical development. One of ways to prevent from iodine deficiency is sufficient intake of iodine with food. The WHO approved method for assessment of the population’s iodine status is measurement of the concentration of iodine in urine. Goal: The goal of the survey was to assess the iodine status in 6-11 years old children and pregnant women. Materials and Method: 1697 children of 6-11 years of age and 900 pregnant women were selected from 21 aimags and Ulaanbaatar city. Concentrations of iodine in their urine were determined using the Sandell-Kolthoff reaction method. Results: The median amount of urinary iodine in 6-11-year-old children was 143.45 µg/L which was within the WHO recommended range (100.0-199.9 µg/L). 31.82% of the surveyed children had their urinary iodine less than 100 µg/L which indicated a risk of iodine deficiency. The highest frequency of children with urinary iodine less than 100 µg/L was observed in western regions (53.9%) and the lowest percentage was observed in eastern regions (17.8%).
The median concentration of urinary iodine in pregnant women was 111.35 100 µg/L which was lower than the WHO recommended value (≥150 µg/L). The median amount of urinary iodine was 127.81 µg/L for the women in Ulaanbaatar city and for those in rural areas was 108 µg/L. The overall percentage of the women with low urinary iodine was 64.1%. Conclusions
1. The median urinary iodine concentration in 6-11 years old children is within the WHO recommended range, whereas the median concentration in pregnant women is lower than the WHO recommended value.
2. 31.8% of the surveyed children and 64.1% of the pregnant women are at risk of iodine deficiency.
3. The frequency of iodine deficiency is highest in western region and is lowest in eastern and central regions.

Introduction: Oligophrenia makes 7.3% of all mental disorders in our country. It is known that almost 4% of all diagnosed cases of oligophrenia developed as a result of an inherited disturbance of amino acid metabolism. In most countries, the frequencies of inherited diseases of amino acid metabolism in the population are determined, and preventive screening programs of newborns are implemented. No study has been conducted so far into the issue of inherited diseases of amino acid metabolism in the Mongolian population. The goal of our survey was to detect inherited disorders of amino acid metabolism in the population at risk. Materials and Methods: The collection of samples and the laboratory analysis were carried out in the following two stages:
1. The screening analysis of 514 individuals diagnosed with mental retardation was performed by paper chromatography;
2. The positivecases detected by the screening were analyzed using high-performance liquid chromatography. Results: The screening testing detected twelve potential disturbances of amino acid metabolism. Out of the twelve positive cases four individuals refused to participate in the confirmatory stage of the survey. Among the remained eight individuals, cases of hypertyrosinemia, hypervalinemia, hyperglycinemia, hyperlysinemia and pyridoxine-dependent epilepsy were detected. Conclusions
1. The fact that cases of inherited disorders of amino acid metabolism were detected among mentally retarded individuals show that the disorder is one of causes of oligophrenia.
2. A screening program of newborns should be implemented for early detection of inherited disorders of amino acid metabolism.
3. A genetic counselling and testing centre could assist in reduction of number of individuals with inherited disorders.

Background:Quality of hospital meals must meet the needs of patients, have a positive effect on disease treatment, and contain nutrients and calorie that fully meet physiological requirements.Goal:We aimed to determine the levels of basic nutrients and the content of calorie in patient meals of public and private hospitals, and evaluate their compliance with policy requirements.Material and Methods:Eighty nine meals for in-patients of three public and three private hospitals were analyzed for the content of protein, fat, carbohydrates, salt and calorie.Results:Analysis results revealed that 100 gr of in-patient meals contained on average 31.97 g of solids, 7.53 g of protein, 17.84 g of carbohydrates, 5.95 g of fat and 155.41 kcal of calorie. The mean level of salt in hospital meals was 2.73 mg/g which was within the WHO recommended range.Conclusions:1. The ratio of nutrients in hospital meals is inappropriate.2. Hospitals should quarterly monitor the levels of nutrients in in-patient meals, and serve meals prepared in view of the analyses results.