Background: In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis. Aim: To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis. Materials and Methods: A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively. Results: At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001). Conclusion The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment of plaque-induced gingivitis.

Background: Demyelinating disorders are a group of chronic immune-mediated diseases affecting myelinated axons in the central nervous system, which lead to life-long disability. In Mongolia, the last regional prevalence study was conducted in 2010. Our study objective is to describe the current prevalence of multiple sclerosis (MS) and other demyelinating disorders in Mongolia. : Aim Materials and Methods: We registered MS, neuromyelitis optica spectrum disease (NMOSD), myelin oligodendrocyte glycoprotein (MOG), and acute disseminated encephalomyelitis (ADEM) cases diagnosed according to the 2017 McDonald criteria, the 2023 NMOSD diagnostic criteria, International MOGAD Panel proposed criteria. Results: The study was conducted in all tertiary, 7 regional, and 20 provincial hospitals across Mongolia and has collected comprehensive data on 965 patients. The prevalence of total demyelinating disorders was estimated to be 27.2, MS 15.6, NMOSD 5.6, MOG 0.06, and ADEM 0.9 per 100,000 total population, respectively. The prevalence of demyelinating disorders between provinces was compared in order of geographical latitude, from lowest to highest, and was statistically significant. Latitude is associated strongly with the prevalence of demyelinating disorders (p=0.006, 95% CI 14.3-22.4, Pearson correlation=0.603) and moderately with the prevalence of MS (p=0.028, 95% CI 9.39-15.6, Pearson correla tion=0.503). Conclusion In Mongolia, the prevalence of MS has significantly increased and can be considered at medium risk, but still much lower than that in Western countries. The prevalence of NMOSD is almost similar to other Asian countries. An obvious latitude gradient for demyelinating disorders was observed in the Mongolian population.

Background: The main risk factors for childhood overweight and obesity include the consumption of sugar-sweetened beverages and other sweetened foods. The sugar content of sugar-sweetened beverages was different from the nutritional information on the packaging. Aim: To determine sugar and brix content in domestic manufactured sugar-sweetened beverages, and compare information on the packaging and regulatory standards. Materials and Methods: The sugar and brix content in sugar-sweetened beverages was determined by laboratory anal ysis, including 150 domestically manufactured sugar-sweetened beverages. Laboratory analysis carried out in the Chemical toxicology laboratory of the National Reference Laboratory for Food Safety, MASM, determined sugar using a saccharometer and brix using refractometry. : Results: The study included 150 Mongolian sugar-sweetened beverages, including 20.7% (n=31) carbonated drinks, 47.3% (n=71) fruit drinks, 16.0% (n=24) tea drinks, 1.3% (n=2) energy drinks, 14.7% (n=22) flavored water. Sugar content 0.0–15.6% in sugar-sweetened beverages. The laboratory analysis results compared with information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). Brix contained 0.2–13.0% carbonated drinks, 4.9–15.7% fruit drinks, 0.6–9.8% tea drinks, 7.7–16.0% energy drinks, and 0.1–9.7% flavored water. Conclusions 1. Sugar content 0.0–15.6%, brix 0.0–16.0% in Mongolian sugar-sweetened beverages. 2. The laboratory analysis results compared with nutritional information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same nutritional information on the packaging, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). 3. 37.3% of Mongolian sugar-sweetened beverages are unsatisfied with regulatory standards.

Introduction: Total environment 24 % of all estimated global deaths are linked to the environment. As of 2022, Ulaanbaatar has a population of 1,691,800, vehicles 435,725, thermal power plants 4, market and shopping centers 111, factories 13,465, and 225 gas stations. Also, 1.5 million tons of waste are generated annually, 1135.6 tons of coal are used, and environmental pollution is increasing year by year. Therefore, it is necessary to investigate the heavy metal contamination of the soil of Ulaanbaatar city and protect the health of the population. Purpose: To determine heavy metals pollution in the soil of Ulaanbaatar city Materials and Methods: We used descriptive research design in this study. Secondary data from Meteorological and Environmental Monitoring Department was used. The content of heavy metals such as lead (Pb), mercury (Hg), chromium (Cr), and cadmium (Cd)) in the soil was evaluated in comparison with the maximum permissible amount specified in the MNS 5850:2019 standard. Statistical analyzing was calculated using SPSS-25 software, and p<0.05 was considered statistically significant. Results: The average concentration of heavy metals in the soil of residential areas of 9 districts of Ulaanbaatar city is cadmium 0.43 mg/kg (min=0, max=26.6), mercury 0.22 mg/kg (min=0, max=4), chromium 11.2 mg/kg ( min=0, max=1609.6), lead is 24.4 mg/kg (min=0, max=257.2). Cadmium concentration in soil Bagakhangai (25%), Baganuur (19.7%), Khan-Uul (18.9%), lead concentration in Nalaikh (8.3%), Bayanzurkh (5.4%), Chingeltei (3.3), mercury concentration in Baganuur ( 24.7%), Khan-Uul (18.4%), and chromium concentration in certain locations of Khan-Uul (4.7%) districts exceeded the standards, respectively. The concentration of soil cadmium (21.2%) and lead (7.7%) near the technical market, mercury concentration (26.3%) near the market and shopping center, and chromium concentration (58.9%) near the central treatment plant exceeded the maximum permissible levels. Conclusion Cadmium and mercury pollution were mainly detected in the heavy metal pollution of the soil of Ulaanbaatar city, and there is heavy metal pollution in certain locations of Baganuur and Khan-Uul districts. Heavy metal pollution is caused by activities such as technical markets, auto repair shops, markets, shopping centers, and treatment plants.

Radon is a radioactive gas that has no smell, colour or taste. Radon is produced from the natural radioactive decay of uranium, which is found in all rocks and soils. Radon can also be found in water. Outdoors, radon quickly dilutes to very low concentrations and is generally not a problem. The average outdoor radon level varies from 5 Bq/m³ to 15 Bq/m³. However, radon concentrations are higher indoors and in areas with minimal ventilation, with highest levels found in places like mines, caves and water treatment facilities. In buildings such as homes, schools, offices, radon levels can vary substantially from 10 Bq/m³ to more than 10 000 Bq/m³.
The effects of residential radon on human health have been studied worldwide since the 1980s. In addition, studies conducted in Europe, North America, and China have proven that even radon levels in dwellings below the acceptable level can pose long-term risks to residents health and contribute to the development of lung cancer. Relying upon the average level of radon and the prevalence of cigarette smoking in the country, radon causes 3-14% of the total incidence of lung cancer. An increase of 100 Bq/m 3 in long time average radon concentration increases the risk of lung cancer by approximately 16%, which is considered that there is a linear relationship between radon concentration and lung cancer.

Healthcare is a rapidly growing industry as medical treatments become more sophisticated, more in demand due to increasing incidence of chronic disease and more widely available worldwide. As the amount of healthcare waste continues to increase, there is a need for further research in the field to meet the global demand for proper disposal of healthcare waste. The growing healthcare consumption, driven by various factors, is contributing to the rise in hospital waste, which in turn is putting pressure on current waste management systems.Currently, healthcare institutions manage waste by segregating at the source, safely transporting infectious waste, and disposing of it through incineration, autoclaving, or landfill methods. Both incineration and autoclaving processes have negative environmental and human health impacts. To reduce the amount of healthcare waste generated, it is necessary to train healthcare workers to properly segregate waste according to its type, following established standards.
Governments can take action to improve waste disposal practices, reduce the generation of infectious waste, and ensure that all types of healthcare waste are properly disposed of. This can include:
• Governments should have clear and standardized definitions for both infectious and non infectious healthcare waste, and enhance the regulatory and legal framework to prevent illegal disposal of waste.
• Healthcare institutions should be provided with incentives, financial support, and other measures to reduce hospital waste, with a particular focus on reducing infectious waste in local health institutions.
• Governments should provide research grants to support studies aimed at reducing and managing healthcare waste disposal effectively.
These measures would help improve the overall management and reduction of healthcare waste and ensure a safer and more sustainable approach to waste disposal.

Introduction: Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change, so we consider to chose to study this topic. Aim: In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two methods is most prevalent for polypectomy. Materials and Method: The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification. Result: The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was 1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia 3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%, 5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study. Conclusions In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa), sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods is equally effective for resection of colon pollyps up to 1 cm in size.

Introduction: On January 31, 2020, the World Health Organization (WHO) declared the infection with coronavirus (COVID-19) an “International Public Health Emergency” and on March 11, 2020, declared it a “Pandemic”. To date, the statistics of the total number of cases of COVID-19 infection is more than 676 million, and the number of deaths is more than 6.8 million. Therefore, reducing the mortality and spread of infection is an urgent issue for the world community. In March 2020, Mongolia confirms its first new case of COVID-19 imported by air transport from abroad. Since then, there have been over 1 million total cases of infection and 2,136 deaths. The aim of this study is to determine some outcomes related to the COVID-19 pandemic in Mongolia. Materials and Methods: We used descriptive research design in this study. Quantitative secondary data about causes of total mortality, COVID-19 cases during the pandemic were analysed from Health Development Center. Also, we conducted cross sectional study on concepts of long COVID-19 condition among 188 people who were recovered from their COVID-19 illness. The SPSS-23 software was used to analyze the data. Results: The mortality rate of the total population of Mongolia in 2021 was compared to this indicator for 2010, 2015, and 2020 and its growth rate was calculated. When calculating the mortality rate of the total population of Mongolia, the number of deaths per 10,000 population in 2021 was 47.4, which is an increase of 11% compared to 2020 in terms of growth rate. As for the causes of mortality growth, cardiovascular deaths increased by 16.7%, deaths of injuries and accidents by 8.2%, and deaths of respiratory diseases increased by 61.1% respectively. There was a positive medium correlation (p=0.007) between the number of cases of COVID-19 infection and the population total mortality.
A total of 188 people were included in the study, with a mean age of 38±12.3 years (minimum=18, maximum=70). Females were 51.1% (96), males were 48.9% (92), males were 6.9% (6.9%), and females were 13.3%. Long COVID-19 condition was found in 20.2% of the respondents. The duration of symptoms after infection with COVID-19 was (23.6%) 3 months, (21%) 1 year, and (23.6) still had symptoms. Symptoms such as fatigue, insomnia, cognitive decline (42.1%), shortness of breath (36.8%), cough, and heartburn appeared. Conclusions
1. During the COVID-19 pandemic in Mongolia, the total mortality of the population has increased, including pneumonia and heart attack. Total mortality of the population during the pandemic depended on the number of cases of COVID-19.
2. About one in five people with COVID-19 answered that observed long-term symptoms of COVID-19, such as fatigue, insomnia, shortness of breath, and cognitive changes, which were more common in women and people with chronic conditions.

Background: To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students. Methods: The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included. Results: A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects. Conclusion In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.

Introduction: Air pollution is one of the greatest environmental risk to health. Ambient air pollution accounts for an estimated 4.2 million deaths per year due to stroke, heart disease, lung cancer and chronic respiratory diseases. Approximately 46% of the population resides in Ulaanbaatar, and over half of the population living in ger (traditional yurt dwelling) areas consumes raw coal, which leads to an increase in ambient air pollutants. The Government of Mongolia took a series of actions to reduce air pollution; one was the ban on the consumption of raw coal beginning on 15 May 2019. The aim of this study is to describe the Ulaanbaatar air quality related to briquettes usage during cold seasons. Material and Methods: We used ecological research design in this study. Quantitative data about air quality of Ulaanbaatar city during the cold seasons (Oct, Nov, Dec, Jan, Feb, Mar, Apr) in 2018-2020 years were analyzed from Department of air quality. These 5 indicators such as sulfur dioxide, nitrogen dioxide, particles (PM_2.5, PM₁₀) and carbon monoxide were selected for statistical analysis. The SPSS-20 software was used to analyze the data. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on 5^th of February, 2021. Results: The average sulfur dioxide, nitrogen dioxide concentrations in the air have increased in October 2019–April 2020 compared to the previous five years. But carbon oxide, particular matter concentrations have decreased in the selected years. Sulfur dioxide (p <0.0001), nitrogen dioxide (p =0.001), PM₁₀(p <0.0001), and PM_2.5 (p <0.0001) are differentiated before and after the use of improved fuels by Wilcoxon signed rank test. However, the CO content did not differ from that of the briquette’s consumption (p =0.412). Conclusions During the cold seasons, the concentration of sulfur dioxide and nitrogen dioxide has increased in air of Ulaanbaatar after used briquettes, while the concentration of particulate matter has decreased during the cold seasons.